摘要
目的通过与传统手术方法比较,探讨内镜下低温等离子消融术联合脱细胞真皮基质补片治疗慢性腹壁窦道的疗效。方法回顾分析2006年1月-2012年5月收治的53例慢性腹壁窦道患者临床资料,其中18例采用内镜下低温等离子消融术联合脱细胞真皮基质补片治疗(试验组),35例采用传统手术方法治疗(对照组)。两组患者性别、年龄、病因、窦道存在时间及部位等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。结果两组单纯手术清理窦道时间相似(t=0.28,P=0.78),但试验组术中清理窦道时出血量、术后住院时间及窦道愈合时间均优于对照组(P<0.05)。试验组无术后窦道出血及感染发生,对照组术后发生5例窦道出血、3例窦道感染,比较差异有统计学意义(P<0.05)。术后两组患者均获随访,试验组随访时间4～18个月,平均12.4个月;对照组6～48个月,平均38.5个月。随访期间均无窦道复发。结论内镜下低温等离子消融术联合脱细胞真皮基质补片治疗慢性腹壁窦道,具有手术视野清晰、坏死肉芽组织清理彻底、术中出血量少、术后窦道愈合快、住院时间短等优点,但远期疗效及安全性仍待进一步观察。
Objective To investigate the effectiveness of endoscopic low-temperature plasma radiofrequency ablation with aceUular dermal matrix patch for chronic abdominal wall sinus by comparing with the traditional surgical method. Methods Retrospective analysis was made on the clinical data of 53 cases of chronic abdominal wall sinus between January 2006 and May 2012. Of 53 patients, 18 underwent endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch （trial group）, and 35 underwent traditional surgical treatment （control group）. No significant difference was found in gender, age, etiology, disease duration, and location between 2 groups （P 〉 0.05）. Results The blood loss during sinus clearance, postoperative hospitalization days, and sinus union time of the trial group were significantly better than those of the control group （P 〈 0.05）, but no significant difference was found in the operative time for sinus clearance （t=0.28, P=-0.78）. No postoperative sinus bleeding or infection occurred in the trial group, but bleeding and infection in 5 and 3 cases of the control group respectively, showing significant differences between 2 groups （P 〈 0.05）. The follow-up time was 4-18 months （mean, 12.4 months） in the trial group, and was 6-48 months （mean, 38.5 months） in the control group. No sinus recurrence was observed during follow-up. Conclusion Endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch has the following advantages in treating chronic abdominal wall sinus： clear view, thorough cleaning of granulation necrosis tissues, less bleeding, faster sinus union, and shorter hospitalization days; however, further observations on the long-term effectiveness and the safety are reauired.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2013年第3期312-315,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
慢性腹壁窦道
低温等离子消融术
脱细胞真皮基质补片
内镜
Chronic abdominal wall sinus Low-temperature plasma radiofrequency ablation Acellulardermal matrix patch Endoscope
