甲状舌管囊肿手术治疗及术后复发再治疗的临床探讨

摘要

Objective To analyze the surgical treatment for thyroglossal cyst/fistula, the causes and opera tion of postoperative recurrence. Methods Forty-eight patients with thyruglossal cyst/fistula were enrolled, inclu-ding 10 recurrent ones. Conventional injection of methylene blue was performed during operation to help resect the whole eyst/fistula. The recurrence rate was recorded during 2 years' follow-up. Results The 38 cases receiving initial operation were cured without recurrence. Among the 10 recurrent ones, 2 were cured after a third operation and showed no recurrence in 2 years. Conclusion The cause of recurrence is incomplete resection of eyst/fintula bran-ches and hyoid bone. Injection of methylene blue for tracing the whole thyroglossal cyst/fistula helps reduce recurrence.%目的 探讨甲状舌管囊肿手术治疗的方法、术后复发的原因及术后复发的再治疗.方法 48例甲状舌管囊肿患者中10例为复发病例,术中常规注人亚甲蓝示踪,根据囊肿的范围、走向及分支,彻底切除.术后随访2年,统计复发率;根据临床资料,分析复发的原因.结果 10例复发患者术中见囊肿周围有瘢痕组织,并有少许炎性肉芽,切除范围加宽至部分正常肌肉组织.亚甲蓝示踪下可见4例由于前次手术切除部分舌骨过窄,舌管后方仍有蓝染的瘘管及小分支存在;6例未切除舌骨,其中2例囊壁紧贴舌骨,4例有小分支穿过舌骨至舌骨后,6例均作舌骨中段切除.所有患者术后伤口愈合良好,未发生手术并发症.初治病例随访2年,未见复发;复发的病例随访2年,2例术后半年再次复发,行第三次手术,痊愈后出院,此后未有复发.结论 舌管细小分支残留、舌骨切除不够是术后复发主要原因.术中注入亚甲蓝有利于完全切除甲状舌管囊肿病灶,控制术后复发率.