颈深部异物术前术中定位方法探讨
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摘要
目的:探讨颈深部异物术前及术中更便捷及准确的定位方法。方法:选取2010-2017年武汉市中心医院颈深部异物患者10例,异物种类均为鱼刺、鸡骨、兔骨等动物骨头类异物,7例未出现明显颈部并发症,3例出现颈部脓肿。对这10例患者术前均行多排薄层CT扫描和B超定位,术中依照术前定位位置寻找异物,若无法找到异物则术中再次行B超定位。结果:10例患者术前均定位到异物,6例患者依照术前CT扫描和B超定位位置顺利找出异物,4例患者术中未找出异物,于术中行B超定位后成功找出异物。结论:术前多排薄层CT扫描和B超联合应用能很准确地定位颈深部异物;术中无法找到异物时,利用术中B超定位可更便捷及准确地寻找异物。
Objective: To explore a more convenient and accurate method for preoperative and intraoperative localization of the neck foreign body. Methods: We selected 10 patients with the neck foreign bodies which caused by animal bones, including 7 cases without obvious neck complications, and 3 cases with cervical abscess. Multiple thin slice CT scans and B-ultrasonography were used on all the 10 patients before surgery, and foreign bodies were searched according to preoperative positioning position.If foreign bodies could not be found, B-ultrasonography was performed again during surgery. Results:Of all the ten patients with preoperative localization to the foreign body, 6 patients were found foreign bodies according to the preoperative CT scans and ultrasound locating position, 4 cases who did not find out the foreign bodies, were successfully found out foreign bodies after the intraoperative localization by B-ultrasonography. Conclusion: The combined application of preoperative multi-slice CT scan and B-ultrasonography can accurately locate the cervical foreign bodies. When intraoperative foreign bodies cannot be found according to the pre-operation location, B-ultrasonography can be used during operation.
Objective: To explore a more convenient and accurate method for preoperative and intraoperative localization of the neck foreign body. Methods: We selected 10 patients with the neck foreign bodies which caused by animal bones, including 7 cases without obvious neck complications, and 3 cases with cervical abscess. Multiple thin slice CT scans and B-ultrasonography were used on all the 10 patients before surgery, and foreign bodies were searched according to preoperative positioning position.If foreign bodies could not be found, B-ultrasonography was performed again during surgery. Results:Of all the ten patients with preoperative localization to the foreign body, 6 patients were found foreign bodies according to the preoperative CT scans and ultrasound locating position, 4 cases who did not find out the foreign bodies, were successfully found out foreign bodies after the intraoperative localization by B-ultrasonography. Conclusion: The combined application of preoperative multi-slice CT scan and B-ultrasonography can accurately locate the cervical foreign bodies. When intraoperative foreign bodies cannot be found according to the pre-operation location, B-ultrasonography can be used during operation.
引文
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[8]王耀文,张媛媛,顾亚军,等.咽喉部鱼刺异物迁移致颈部脓肿分析[J].中国耳鼻咽喉头颈外科,2016,23:716-718.Wang YW,Zhang YY,Gu YJ,et al. Neck abscess caused by foreign body of fish bone in pharynx[J]. Chin Arch Otolaryngol Head Neck Surg,2016,23:716-718.
[2] Wang CP,Jiang SL. Migrating fish bone presenting as acute onset of neck lump[J]. Formos Med Assoc,2009,108:170-172.
[3] Al-Sebeih K,Valvoda M,Sobeih A,et al. Perforating and migrating pharyngeal foreign bodies:a series of 5patients[J]. Ear Nose Throat,2006,85:600-603.
[4]邬旭,刘璩,关庆捷.咽异物迁移所致颈部包块的诊治[J].中华耳鼻咽喉头颈外科杂志,2006,41:516-518.Wu X,Liu J,Guan QJ. Diagnosis and treatment for the neck lump caused by migrating foreign body from the pharynx[J]. Chin J Otorhinolaryngol Head Neck Surg,2006,41:516-518.
[5] Chung SM,Kim HS,Park EH. Migrating pharyngeal foreign bodies:a series of four cases of saw-toothed fish bones[J]. Eur Arch Otorhinolaryngol,2008,265:1 125-1 129.
[6] Robbins KT,Clayman G,Levine PA,et al. Neck dissection classification update[J]. Arch Otolaryngol Head Neck Surg,2002,128:751-752.
[7]车娜,葛荣明,毛涌.颈部异物诊治分析[J].中国耳鼻咽喉头颈外科,2012,19:454-456.Che N,Ge RM,Mao Y. Diagnosis and treatment of neck migrating forein bodies[J]. Chin Arch Otolaryngol Head Neck Surg,2012,19:454-456.
[8]王耀文,张媛媛,顾亚军,等.咽喉部鱼刺异物迁移致颈部脓肿分析[J].中国耳鼻咽喉头颈外科,2016,23:716-718.Wang YW,Zhang YY,Gu YJ,et al. Neck abscess caused by foreign body of fish bone in pharynx[J]. Chin Arch Otolaryngol Head Neck Surg,2016,23:716-718.