目的 探讨甲状舌管囊肿患者经Sistrunk手术治疗后的临床疗效及其术后复发影响因素分析.方法 选取2019年5月至2022年5月我院收治的80例甲状舌管囊肿患者作为研究对象,采用Sistrunk术式对所有的甲状舌管囊肿患者进行治疗.观察80例患者的术后恢复情况、并发症发生情况.对所有患者进行为期两年的随访,统计Sistrunk术后甲状舌管囊肿的复发率.分析并评估Sistrunk手术后甲状舌管囊肿复发的相关可能因素.计量数据比较采用 t 检验.结果 所有患者术后病理检查均证实为甲状舌管囊肿,术后咽部无明显不适,呼吸及吞咽正常,发音无改变.术后出现局部感染患者4例,给予清创换药和抗感染治疗10 d后恢复正常.对80例患者进行2年的随访,有5例患者术后出现复发,总体复发率为6.25％(5/80).单因素分析结果显示,Sistrunk手术后,复发组与非复发组患者的年龄、性别、BMI、囊肿直径等指标比较,差异无统计学意义(Z=0.380、0.120、0.280、0.060,P＞0.05);复发组患者的术前感染比例和术后感染比例明显高于非复发组患者,差异有统计学意义(Z=3.650、4.240,P＜0.05).在既往行Sistrunk手术后的9例复发患者中,前次Sistrunk手术在感染炎症期进行导致感染灶未彻底清除的患者为1例;前次Sistrunk手术舌骨切除过短以致瘘管上皮残留的患者为4例;前次Sistrunk手术未能完整切除甲状舌管的细小分支的患者为3例.结论 Sistrunk手术治疗初次发病和再次复发的甲状舌管囊肿均可取得良好的效果,术前感染、术后感染和规范实施Sistrunk手术均是影响甲状舌管囊肿复发的重要因素.
Factor analysis of recurrent thyroglossal duct cyst after Sistrunk surgery
Objective To investigate the clinical effect of thyroglossal duct cyst treated by Sistrunk and the factors influencing its recurrence.Methods 80 patients with thyroglossal duct cyst admitted to our hospital from May 2019 to May 2022 were selected as the study objects,and Sistrunk surgery was used to treat all patients with thyroglossal duct cyst.The postoperative recovery and complications of 80 patients were observed.All patients were followed up for two years to determine the recurrence rate of thyroglossal duct cyst after Sistrunk.Analyze and evaluate the possible factors related to the recurrence of thyroglossal cyst after Sistrunk surgery.The t-test is used for comparing measurement data.Results All patients were found to have thyroglossal duct cyst by pathological examination after surgery.There was no obvious dis-comfort in the pharynx,normal breathing and swallowing,and no change in pronunciation.Local infection occurred in 4 patients after operation,which recovered after 10 days of debridement and anti-infection treat-ment.The 80 patients were followed up for 2 years,and 5 patients recurred after surgery,with an overall recurrence rate of 6.25％(5/80).Univariate analysis showed that there was no significant difference in age,gender,BMI,cyst diameter and other indexes between the recurrent group and the non-recurrent group after Sistrunk surgery(Z=0.380,0.120,0.280,0.060,P＞0.05).The proportion of preopera-tive infection and postoperative infection in the recurrent group was significantly higher than that in the non-recurrent group(Z=3.650,4.240,P＜0.05).Among the 9 patients with recurrence after Sistrunk sur-gery,there was 1 patient whose infection lesion was not completely cleared after the previous Sistrunk sur-gery in the inflammatory period.There were 4 patients with fistula epithelium remaining due to short hyoid resection during the previous Sistrunk operation,and 3 patients failed to completely remove the small branch of thyroglossal duct after the previous Sistrunk operation.Conclusion Sistrunk surgery can achieve good results in the treatment of both primary onset and recurrent thyroglossal duct cyst.Preoperative infec-tion,postoperative infection and standard Sistrunk operation are important factors affecting the recurrence of thyroglossal duct cyst.
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