治疗朝天鼻窦的现代技术

V. S. Groshilin, E. I. Kharabet, A. A. Pogosyan, V. D. Kuznetsov, O. A. Dubinskiy
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摘要

目标:通过开发和验证两阶段治疗方法(使用激光治疗和随后的根治性外科手术),改善朝天鼻患者的治疗效果并减少复发次数。通过开发和验证两阶段治疗方法(使用激光治疗和随后的根治性手术干预),改善朝天鼻病患者的治疗效果并减少复发次数。 材料与方法。对罗斯托夫国立医科大学临床基地 76 名患者的治疗结果进行了前瞻性分析。患者被分为三个临床观察组:第一组(主要组,26 名患者)按照原始技术(专利号 2770283)进行两阶段治疗。在第二组(第一对照组,28 名观察对象)中,我们根据经 Karydakis 改良的 Bascom 正宗方法 Bascom II 方法,采用了 "сleft lift "程序。)在第三组(第二对照组,22 名观察者)中,我们采用骶尾部整形手术的传统技术剥离朝天鼻窦,并沿臀裂进行 "聋 "字缝合。 结果。结果分析表明,由于手术缺损面积较小,且手术阶段为根治性,局部无炎症组织反应,因此 I 组患者术后恢复较为顺利。按照最初的两阶段方法进行手术的患者没有出现明显的浸润性炎症并发症。在一年的门诊随访期间,没有出现复发情况。根据 VAS 评分,I 组患者的术后疼痛综合征明显较轻。与对照组的相同参数相比,主治组患者的住院时间和残疾时间均有所缩短。与传统手术治疗方法相比,药物经济学效果明显,因为手术伤口愈合较早,软组织炎症反应较小,化脓并发症风险降低。 结论所开发的两阶段手术治疗朝天鼻窦的方法有助于提高根治性治疗的效果,减少复发和并发症的数量,缩短患者残疾的时间。该技术疗效显著,可实现早期愈合和稳定的美学效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern technologies in treatment of pilonidal sinus
Objective. Improvement of treatment results and reduction of the number of relapses in patients with pilonidal disease, by developing and substantiating a two-stage treatment method (with the use of laser treatment and subsequent radical surgical intervention).   Materials and Methods. A prospective analysis of the treatment results of 76 patients at the clinical sites of the Rostov State Medical University was carried out. The patients were divided into three clinical observation groups: In Group I (the main group, 26 patients), two-stage treatment was carried out according to the original technique (patent № 2770283). In Group II (the first control group, 28 observations), we used the "сleft lift" procedure according to the Bascom authentic method Bascom II method modified by Karydakis). In Group III (the second control group, 22 observations), the pilonidal sinus was dissected with the traditional technique of plastic surgery of the sacrococcygeal region with "deaf" sutures along the gluteal cleft.   Results. Analysis of the results showed that the postoperative period was smoother in Group I patients due to the smaller size of the surgical defect and the radical surgical stage in the absence of local inflammatory tissue reaction. There were no significant infiltrative-inflammatory complications in the patients operated on according to the original two-stage method. There were no recurrences during the one-year outpatient follow-up period. According to the VAS score, postoperative pain syndrome was significantly lower in Group I patients. The duration of hospitalization and period of disability were reduced in the patients of the main group in comparison with the same parameters in the control groups. The indicated pharmaco-economic effect in comparison with the traditional methods of surgical treatment was obtained due to early healing of the operative wounds with a smaller inflammatory reaction of the soft tissues and a reduced risk of suppurative complications.   Conclusion. The developed method of two-stage surgical treatment of pilonidal sinus helps to increase the effectiveness of radical treatment, reduce the number of relapses and complications, and reduce the duration of patients' disability. The described efficacy of the technology is achieved with early healing and stable qualitative aesthetic result.
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