单纯肿物切除与腮腺部分切除加面神经解剖治疗腮腺良性肿瘤的疗效分析
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摘要
目的:观察单纯肿物切除与腮腺部分切除加面神经解剖治疗腮腺良性肿瘤的效果。方法:回顾性分析2013年1月-2016年12月本院行腮腺良性肿物手术治疗的86例患者的临床资料。根据术式不同分为观察组(行腮腺部分切除加面神经解剖术)和对照组(行单纯肿物切除术),各43例。观察两组手术前后唾液功能、术后味觉出汗综合征发生情况、手术情况、并发症和复发率。结果:手术前后,两组唾液功能的组内与组间比较差异均无统计学意义(P>0.05);观察组手术时间长于对照组,术中出血量多于对照组(P<0.05);观察组术后复发率2.33%,明显低于对照组的16.28%(P<0.05);两组味觉出汗综合征发生情况、并发症发生率比较,差异均无统计学意义(P>0.05),且均无重度味觉出汗综合征发生。结论:对于良性腮腺肿瘤,腮腺部分切除加面神经解剖术的临床疗效、术后并发症等情况与单纯肿物切除无明显差别,但是能够明显降低患者术后复发率。
Objective:To observe the curative effect of simple tumor resection and partial parotid resection and facial nerve anatomy in treatment of benign parotid tumors.Method:The clinical data of 86 patients with benign parotid masses treated by surgical treatment in our hospital from January 2013 to December 2016 were retrospectively analyzed.According to the different surgical methods,they were divided into observation group(partial parotid resection and facial nerve anatomy) and control group(simple tumor resection),43 cases in each group.The saliva function before and after operation,the occurrence of postoperatively gustatory sweating syndrome,operation conditions,complications and recurrence rate were observed between two groups.Result:Before and after operation,the saliva function of intra group and inter group in two groups were compared,the differences were not statistically significant(P>0.05).The operation time in observation group was longer than that in control group,and intraoperative bleeding volume in observation group was more than that of control group(P<0.05).The recurrence rate of observation group was 2.33%,which was significantly lower than 16.28% of control group(P<0.05).The gustatory sweating syndrome and complications in two groups were compared,the differences were not statistically significant(P>0.05),and no severe taste sweating syndrome occurred.Conclusion:For benign parotid tumors,there is no significant difference in clinical efficacy and postoperative complications between partial parotid resection and facial nerve anatomy,but it can significantly reduce postoperative recurrence rate.
Objective:To observe the curative effect of simple tumor resection and partial parotid resection and facial nerve anatomy in treatment of benign parotid tumors.Method:The clinical data of 86 patients with benign parotid masses treated by surgical treatment in our hospital from January 2013 to December 2016 were retrospectively analyzed.According to the different surgical methods,they were divided into observation group(partial parotid resection and facial nerve anatomy) and control group(simple tumor resection),43 cases in each group.The saliva function before and after operation,the occurrence of postoperatively gustatory sweating syndrome,operation conditions,complications and recurrence rate were observed between two groups.Result:Before and after operation,the saliva function of intra group and inter group in two groups were compared,the differences were not statistically significant(P>0.05).The operation time in observation group was longer than that in control group,and intraoperative bleeding volume in observation group was more than that of control group(P<0.05).The recurrence rate of observation group was 2.33%,which was significantly lower than 16.28% of control group(P<0.05).The gustatory sweating syndrome and complications in two groups were compared,the differences were not statistically significant(P>0.05),and no severe taste sweating syndrome occurred.Conclusion:For benign parotid tumors,there is no significant difference in clinical efficacy and postoperative complications between partial parotid resection and facial nerve anatomy,but it can significantly reduce postoperative recurrence rate.
引文
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[15]王忠.改良型腮腺切除术与传统手术治疗腮腺肿瘤的临床比较[J].中外医疗,2012,31(6):109.
[16]Günizi H,Güney K.Our surgical approach to parotid masses:ananalysis of 130 patients[J].Kulak Burun Bogaz Ihtis Derg,2013,23(2):85-89.
[17]Al-Khtoum N,Qubilat A R,Al-Zaidaneen S,et al.Clinical characteristics of pleomorphic adenoma of salivary glands among Jordanian patients[J].J Pak Med Assoc,2013,63(3):358-360.
[18]Thahim K,Udaipurwala I H,Kaleem M.Clinical manifestations,treatment outcome and post-operative complications of parotid gland tumours-an experience of 20 cases[J].J Pak Med Assoc,2013,63(12):1472-1475.
[19]Singh L R,Arun K K,Devi P G,et al.Pattern of salivary gland tumors in Manipur,India:A 10 year study[J].South Asian J Cancer,2013,2(4):250-253.
[20]梁艳,张永超,谷京城.腮腺肿瘤切除术面神经保护的研究进展[J].辽宁医学院学报,2013,34(6):66-68.
[2]李晨曦.腮腺浅叶的不同术式治疗腮腺良性肿瘤效果的meta分析[D].乌鲁木齐:新疆医科大学,2016.
[3]付志新.腮腺良性肿瘤手术治疗的回顾性分析[D].太原:山西医科大学,2014.
[4]黄春姐,陈敏军,黄月燕.解剖游离保留面神经应用于腮腺肿瘤手术的临床体会[J].中国医学创新,2014,11(33):122-124.
[5]刘洪,李超,樊晋川,等.腮腺手术切除术中两种解剖方式对面神经功能的影响[J].中国肿瘤临床,2014,41(17):1120-1124.
[6]王学义,邹卿,王露.特发性面神经麻痹临床分析[J].华西医学,2014,29(8):1413-1415.
[7]王震,张岩,陈伟东,等.腮腺良性肿物手术方式选择-面神经保护及功能保留[J].临床耳鼻咽喉头颈外科杂志,2013,27(11):611-612.
[8]吕继连,张瑞,张帅.腮腺良性肿瘤2种解剖面神经术式术后面神经损伤的临床研究[J].临床耳鼻咽喉头颈外科杂志,2017,31(6):456-460.
[9]任晓旭,牛勇梅,秦晓中,等.区域性或浅叶切除术治疗腮腺浅叶良性肿瘤临床对比研究[J].临床口腔医学杂志,2014,35(8):497-499.
[10]罗志桓,陈金伟,黄敏晖,等.腮腺良性肿瘤的外科手术治疗方式及其并发症分析[J].临床医学工程,2014,21(4):477-478.
[11]梁军,荆少红,吴振婵,等.腮腺多形性腺瘤包膜特征与手术边界的确定[J].中国口腔颌面外科杂志,2013,11(6):477-480.
[12]王学斌.腮腺腺淋巴瘤的MSCT诊断及鉴别诊断[J].中国医学创新,2014,11(4):11-12.
[13]张莉.两种术式治疗腮腺良性肿瘤的疗效对比[J].中国现代医药杂志,2016,18(7):34-36.
[14]霍俊峰,国庆,郭建峰.腮腺术后负压引流与橡皮片加压包扎临床疗效比较[J].中国实用口腔科杂志,2012,5(8):511-512.
[15]王忠.改良型腮腺切除术与传统手术治疗腮腺肿瘤的临床比较[J].中外医疗,2012,31(6):109.
[16]Günizi H,Güney K.Our surgical approach to parotid masses:ananalysis of 130 patients[J].Kulak Burun Bogaz Ihtis Derg,2013,23(2):85-89.
[17]Al-Khtoum N,Qubilat A R,Al-Zaidaneen S,et al.Clinical characteristics of pleomorphic adenoma of salivary glands among Jordanian patients[J].J Pak Med Assoc,2013,63(3):358-360.
[18]Thahim K,Udaipurwala I H,Kaleem M.Clinical manifestations,treatment outcome and post-operative complications of parotid gland tumours-an experience of 20 cases[J].J Pak Med Assoc,2013,63(12):1472-1475.
[19]Singh L R,Arun K K,Devi P G,et al.Pattern of salivary gland tumors in Manipur,India:A 10 year study[J].South Asian J Cancer,2013,2(4):250-253.
[20]梁艳,张永超,谷京城.腮腺肿瘤切除术面神经保护的研究进展[J].辽宁医学院学报,2013,34(6):66-68.