国际儿科学杂志
國際兒科學雜誌
국제인과학잡지
INTERNATIONAL JOURNAL OF PEDIATRICS
2014年
4期
418-420
,共3页
吴伟(综述)%吕志葆(审校)
吳偉(綜述)%呂誌葆(審校)
오위(종술)%려지보(심교)
梨状窝瘘%钡餐%胃镜%诊断%治疗
梨狀窩瘺%鋇餐%胃鏡%診斷%治療
리상와루%패찬%위경%진단%치료
Pyriform sinus fistula%Barium esophagography%Endoscopy%Diagnosis%Treatment
梨状窝瘘多以小儿反复发作的单侧(左侧为主)颈部炎性脓肿或急性化脓性甲状腺炎等症状就诊,以往在治疗上多为反复颈部脓肿切开引流及联合多种抗生素对症缓解症状或是开放性常规分离瘘管手术寻求根治,但复发率较高。该文通过总结近年梨状窝瘘相关诊断和治疗进展,旨在强调对于疑似患儿需及时行超声、CT、上消化道钡餐等检查,必要时做内镜检查,治疗上在非急性期以内镜辅助下导管置入或亚甲蓝内口注射行梨状窝瘘切除术可明显减少复发率。
梨狀窩瘺多以小兒反複髮作的單側(左側為主)頸部炎性膿腫或急性化膿性甲狀腺炎等癥狀就診,以往在治療上多為反複頸部膿腫切開引流及聯閤多種抗生素對癥緩解癥狀或是開放性常規分離瘺管手術尋求根治,但複髮率較高。該文通過總結近年梨狀窩瘺相關診斷和治療進展,旨在彊調對于疑似患兒需及時行超聲、CT、上消化道鋇餐等檢查,必要時做內鏡檢查,治療上在非急性期以內鏡輔助下導管置入或亞甲藍內口註射行梨狀窩瘺切除術可明顯減少複髮率。
리상와루다이소인반복발작적단측(좌측위주)경부염성농종혹급성화농성갑상선염등증상취진,이왕재치료상다위반복경부농종절개인류급연합다충항생소대증완해증상혹시개방성상규분리루관수술심구근치,단복발솔교고。해문통과총결근년리상와루상관진단화치료진전,지재강조대우의사환인수급시행초성、CT、상소화도패찬등검사,필요시주내경검사,치료상재비급성기이내경보조하도관치입혹아갑람내구주사행리상와루절제술가명현감소복발솔。
Pyriform sinus fistula,owing to rare disease incidence and lacking of awareness,is always a puzzle to neck illness. At the mean time,The frequent delay in accurate diagnosis was reported in the literature. Pyriform sinus fistula should be considered in any children with repeated neck or thyroid infection/mass( mainly on the left side) . The combination of barium esophagography,CT scan and ultrasound is useful to establish the diagnosis. Intraoperative endoscopy-assisted intubation or methylene blue injection through the internal opening as a guide can facilitate identification of the tract during dissection,and it can effectively reduce the relapse rate.