微创手术治疗鳃裂囊肿的回顾性研究

发布时间：2018-03-13 19:39

本文选题：鳃裂囊肿　切入点：微创手术　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：评估微创手术作为一种新的治疗鳃裂囊肿的方法的可行性。背景：鳃裂囊肿是头颈部肿瘤中的一种常见疾病，属于先天性疾病，病因机制不甚明确，根据发病来源将其分为四类，其中第二鳃裂囊肿在临床上最为常见，位置多在单侧颈部。其手术治疗方法可作为颈部肿瘤手术切除的代表。传统的第二鳃裂囊肿切除术即在颈部做一全层横断切口，这样不仅影响美观，手术创伤也大，手术及术后恢复时间较长，术后疼痛反应重，瘢痕较为明显。颈部是需要暴露在外的区域，并且考虑到鳃裂囊肿的好发年龄多为年轻人，美观是个需要重视的问题。微创手术在创口小，美观，损伤小等方面有巨大优势，早期专指腹腔镜手术，近年来已经被学者们尝试应用于各个领域和部位。材料与方法：选取2007年至2009年间就诊于我院的26名患有第二鳃裂囊肿的患者进行临床研究。在经过患者及家属同意下，将其分为两组，实验组中有15名患者采用微创手术来治疗，对照组中11名患者采用传统方法进行治疗。所有入组患者均有详细记录的病史，病程记录以及手术记录等资料，实验室辅助检查结果以及病理结果均有记录。通过对两组患者的手术麻醉方式，手术时间，术后疼痛程度，切口大小以及两年随访的结果来评估新方法的可行性。结果：通过实验研究对比，实验组的手术方法，即采用微创的手术，主要采用局部麻醉来进行，整个手术过程平均时长为52.0分钟，较传统手术方法平均时长的70.45分钟明显缩短。另外，实验组中，微创手术所形成的切口平均长度为2.17厘米，对照组为5.59厘米。实验组患者术后不良反应及疼痛明显较对照组减少。两年随访两组病例中，未见有复发病例；实验组患者平均瘢痕长度较对照组的明显较短，，且对照组病例均有较明显的瘢痕。结论：微创手术可以作为治疗鳃裂囊肿的一种，并在一定程度上能更好的被患者接受。
[Abstract]:Objective: to evaluate the feasibility of minimally invasive surgery as a new method for the treatment of branchial cleft cysts. Background: branchial cleft cyst is a common disease in head and neck tumors. It is a congenital disease, and its etiology is not clear. According to its origin, branchial cleft cyst is classified into four categories, among which the second branchial cleft cyst is the most common in clinic. The traditional resection of the second branchial cleft cyst is to make a full-layer incision in the neck, which not only affects the beauty, but also has a great trauma. The neck is the area that needs to be exposed, and considering that the most common age of branchial cleft cysts is young people. Minimally invasive surgery has great advantages in the aspects of small wound, beautiful appearance, little injury, etc. In recent years, it has been applied to various fields and parts by scholars. Materials and methods: 26 patients with second branchial cleft cyst from 2007 to 2009 were selected and divided into two groups with the consent of the patients and their families. Fifteen patients in the experimental group were treated with minimally invasive surgery, 11 patients in the control group were treated with traditional methods. The feasibility of the new method was evaluated by anaesthesia, operation time, postoperative pain, incision size and two-year follow-up results. Results: compared with the experimental study, the operation methods of the experimental group, I. e., the minimally invasive operation, were mainly performed by local anesthesia. The average duration of the whole operation process was 52.0 minutes. In addition, in the experimental group, the average length of incision formed by minimally invasive surgery was 2.17 cm. The adverse reactions and pain in the experimental group were significantly lower than those in the control group. There were no recurrence cases in the two groups, and the average scar length in the experimental group was significantly shorter than that in the control group, and the mean scar length in the experimental group was significantly shorter than that in the control group. All the cases in the control group had obvious scar. Conclusion: minimally invasive surgery can be used to treat branchial cleft cysts and to some extent be better accepted by patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.7

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