基于咽皮肤瘘临床分期的治疗原则
Treatment Principle Based on the Clinical Staging of Pharyngocutaneous Fistula.
作者信息
Sun Wei, Ma Ren-Qiang, Wen Wei-Ping, Zhu Xiao-Lin
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Institute of Otorhinolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou 510080, China.
出版信息
Int J Otolaryngol. 2020 May 14;2020:2373549. doi: 10.1155/2020/2373549. eCollection 2020.
OBJECTIVE
Studies on factors affecting pharyngocutaneous fistulas (PCFs) and PCF repair methods have been widely reported. However, the healing phases of PCF are unclear, and their elucidation could guide clinical treatment.
METHODS
Clinical stages of the PCF healing process were identified by a retrospective study of 39 patients with head and neck cancer who developed a PCF.
RESULTS
Different conservative treatments were performed in turn according to three defined stages of the PCF healing process: stage I (drainage and debriding period), stage II (pressure dressing period), and stage III (healing period). A 7-day course of antibiotic therapy was only performed in stage I in 23 patients. The PCF was cured in 30 (76.9%) of 39 patients; the remaining 9 patients underwent subsequent surgical interventions for PCF healing.
CONCLUSION
The three stages of PCF healing have a certain reference value in guiding clinical treatments. Moreover, antibiotics should be used in stage I when signs of infection are present, but they should not be used in all three phases of conservative treatment.
目的
关于影响咽瘘（PCF）的因素及PCF修复方法的研究已有广泛报道。然而，PCF的愈合阶段尚不清楚，对其进行阐明可为临床治疗提供指导。
方法
通过对39例发生PCF的头颈癌患者进行回顾性研究，确定PCF愈合过程的临床阶段。
结果
根据PCF愈合过程的三个明确阶段依次进行不同的保守治疗：第一阶段（引流清创期）、第二阶段（加压包扎期）和第三阶段（愈合期）。23例患者仅在第一阶段进行了为期7天的抗生素治疗。39例患者中有30例（76.9%）的PCF治愈；其余9例患者随后接受了PCF愈合的手术干预。
结论
PCF愈合的三个阶段对指导临床治疗具有一定参考价值。此外，在出现感染迹象时应在第一阶段使用抗生素，但不应在保守治疗的所有三个阶段都使用。
Zotero 插件