王灿

[摘要] 目的 探讨清扫式耳前瘘管摘除术治疗耳前痿管感染期的手术效果以及临床应用价值。 方法 方便选取该院2017年1月—2018年5月期间内接收的30例耳前痿管感染期患者作为观察对象，另外选取同期该院接收的15例耳前痿管感染完全控制的患者作为对照组。给予两组患者均行清扫式耳前瘘管摘除术治疗。对比两组患者手术治疗效果，并观察治疗基本情况、并发症发生情况以及复发情况。 结果 ①两组患者经治疗后Ⅰ期愈合率比较差异无统计学意义（P>0.05）;②观察组经治疗后疼痛消失时间（2.09±0.61）d、脓腔消失时间（9.02±1.06）d、治愈时间（12.15±1.24）d较对照组来说均更低，，差异有统计学意义（t=3.189、26.019、40.017，P<0.05）;③观察组总并发症发生率占比3.33%，对照组占比20.00%，两组患者总并发症发生率比较，差异有统计学意义（χ2=13.484，P=0.000，P<0.05），且两组患者均未见一例复发。 结论 耳前痿管感染期患者接受清扫式耳前瘘管摘除术治疗效果确切，促进了患者的快速康复，降低了并发症以及复发的几率，临床实用价值较高，并且能够满足患者的美学需求，值得加以推广使用。

[关键词] 清扫式耳前瘘管摘除术;耳前痿管;感染期;手术效果;美学效果

[中图分类号] R764          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0085-03

[Abstract] Objective To investigate the surgical effect and clinical application value of cleaning anterior auricular fistula removal in the treatment of pre-auricular impotence in infectious period. Methods A total of 30 patients with pre-auricular impotence during the period from January 2017 to May 2018 were selected as the observation group， and 15 patients with pre-auricular impotence under complete control were selected as the control group during the same period. The patients in both groups were treated with cleaning anterior auricular fistula removal. The curative effect of operation was compared between the two groups， and the basic condition of treatment， complications and recurrence were observed. Results There was no statistically significant difference in the first stage healing rate between the two groups after treatment （P>0.05）. The pain disappearance time （2.09±0.61） d， the pus cavity disappearance time （9.02±1.06） d and the healing time （12.15±1.24） d in the observation group were lower than those in the control group. （t=3.189， 26.019， 40.017，P<0.05）. The incidence of total complications in the observation group was 3.33% and that in the control group was 20.00%（χ2=13.484， P=0.000 <0.05）， and there was no recurrence in either group. Conclusion Sweeping anterior auricular fistula removal is effective for patients with preauricular impotence in infection stage， which promotes rapid recovery of patients， reduces the risk of complications and recurrence. It has high clinical practical value， and can meet the aesthetic needs of patients， and is worth popularizing.

[Key words] Cleaning type of anterior iliac crest extraction; Pre-ankle fistula; Infection period; Surgical effect; Aesthetic effect

耳前痿管是臨床中较为常见的一种先天性畸形，患者临床可表现为局部搔痒并伴随白色分泌物。国外研究报道，耳前痿管主要是由于常染色体显性遗传。并且李海澜[1]学者研究中曾提出，耳前痿管具有不规则显性，主要为人体胚胎发育时期第1、2鳃弓耳廓原基融合不良或封闭不全所导致。耳前痿管由于临床表现不典型，不易引起患者重视，若患者局部搔痒后抓破感染，会导致形成脓肿，从而加大了临床治疗的难度。局部穿刺治疗曾被用于治疗耳前痿管，但该术清除病理产物不够彻底，易导致复发，患者接受程度较低。近年来，清扫式耳前瘘管摘除术应用逐渐增多，耳前痿管感染期时，应通过局部热敷等方式控制炎症，若有脓肿形成，则应切开脓肿后再行清扫式耳前瘘管摘除术治疗[2]。基于……