耳后隐蔽切口与改良S切口在良性腮腺肿瘤切除术中的应用价值比较
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摘要
目的比较耳后隐蔽切口与改良S切口在良性腮腺肿瘤切除术中的应用价值。方法良性腮腺肿瘤患者120例,随机分为耳后隐蔽切口组和改良S切口组各60例。观察手术情况、术后并发症及复发情况,并比较两组手术前后的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果两组患者手术时间、术中出血量、术后引流量、Frey's综合征、耳部皮肤麻木、暂时性面瘫、感染和涎瘘等并发症发生率及复发率比较,差异均无统计学意义(P>0.05)。两组均无发生永久性面瘫和术后出血的病例。术后6个月,耳后隐蔽切口组的SAS评分及SDS评分较前降低(P<0.05),而改良S切口组SAS评分及SDS评分较前升高(P<0.05)。术后6个月,耳后隐蔽切口组患者的SAS评分及SDS评分均低于改良S切口组(P<0.05)。结论与改良S切口相比,耳后隐蔽切口行良性腮腺肿瘤切除术安全有效,并改善患者术后的焦虑和抑郁情绪。
Objective To compare the application value between posterior auricular incision and modified S-shaped incision in resection for benign tumor of parotid gland. Methods A total of 120 patients with benign tumor of parotid gland were randomly signed to posterior auricular incision group or modified S-shaped incision group,with 60 cases in each group. The operation situation,postoperative complications and recurrence were observed. And Self-Rating Anxiety Scale( SAS) and Self-Rating Depressive Scale( SDS) were assessed between two groups before and after surgery. Results There were no significant differences in operation duration,intraoperative blood loss,postoperative drainage volume,the incidences of Frey's syndrome,ear skin numbness,temporary facial paralysis,infection and salivary fistula,or recurrence rate between two groups( P > 0. 05). No patients suffered from permanent facial paralysis or postoperative bleeding in both groups. After 6 months of surgery,SAS score and SDS score decreased in the posterior auricular incision group( P < 0. 05),but increased in the modified S-shaped incision group( P < 0. 05). After 6 months of surgery,SAS score and SDS score in the posterior auricular incision group were lower than those in the modified S-shaped incision group( P < 0. 05). Conclusion Compared with modified S-shaped incision,posterior auricular incision is safe and effective for the treatment of benign tumor of parotid gland,and can improve anxiety and depression of the patients after surgery.
Objective To compare the application value between posterior auricular incision and modified S-shaped incision in resection for benign tumor of parotid gland. Methods A total of 120 patients with benign tumor of parotid gland were randomly signed to posterior auricular incision group or modified S-shaped incision group,with 60 cases in each group. The operation situation,postoperative complications and recurrence were observed. And Self-Rating Anxiety Scale( SAS) and Self-Rating Depressive Scale( SDS) were assessed between two groups before and after surgery. Results There were no significant differences in operation duration,intraoperative blood loss,postoperative drainage volume,the incidences of Frey's syndrome,ear skin numbness,temporary facial paralysis,infection and salivary fistula,or recurrence rate between two groups( P > 0. 05). No patients suffered from permanent facial paralysis or postoperative bleeding in both groups. After 6 months of surgery,SAS score and SDS score decreased in the posterior auricular incision group( P < 0. 05),but increased in the modified S-shaped incision group( P < 0. 05). After 6 months of surgery,SAS score and SDS score in the posterior auricular incision group were lower than those in the modified S-shaped incision group( P < 0. 05). Conclusion Compared with modified S-shaped incision,posterior auricular incision is safe and effective for the treatment of benign tumor of parotid gland,and can improve anxiety and depression of the patients after surgery.
引文
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[3]李婷.颜面部烧伤后早期疤痕治疗的护理干预[J].中国继续医学教育,2015,7(26):205-206.
[4]季平,陈睿,扬凯,等.隐蔽切口、胸锁乳突肌肌瓣改良术式在腮腺区域手术中的临床应用[J].重庆医学,2005,34(3):336-338.
[5]Gainotti G,Cianchetti C,Taramelli M,et al.The guided selfrating anxiety-depression scale for use in clinical psychopharmacology[J].Act Nerv Super(Praha),1972,14(1):49-51.
[6]Zung WW.A self-rating depression scale[J].Arch Gen Psychiatry,1965,12:63-70.
[7]O'Brien CJ.Current management of benign parotid tumors--the role of limited superficial parotidectomy[J].Head Neck,2003,25(11):946-952.
[8]Vieira MB,Maia AF,Ribeiro JC.Randomized prospective study of the validity of the great auricular nerve preservation in parotidectomy[J].Arch Otolaryngol Head Neck Surg,2002,128(10):1 191-1 195.
[9]冉屹东,周彪.改良型腮腺切除术治疗腮腺肿瘤的临床优势评估[J].中国肿瘤临床与康复,2015,22(2):158-160.
[10]郭琦.改良型腮腺切除术与传统切除术治疗腮腺肿瘤的临床治疗效果对比[J].中国实用医药,2014,9(4):32-33.
[11]赵亚东,陈玉友,张硕,等.改良美容切口在腮腺良性肿瘤切除术中的临床应用探讨[J].内蒙古医学杂志,2015,47(12):1 497-1 499.
[12]Roh JL.Extracapsular dissection of benign parotid tumors using a retroauricular hairline incision approach[J].Am J Surg,2009,197(5):e53-e56.
[2]O'Connor T.Mental health nursing--'a good fit'[J].Nurs N Z,2015,21(8):20-21.
[3]李婷.颜面部烧伤后早期疤痕治疗的护理干预[J].中国继续医学教育,2015,7(26):205-206.
[4]季平,陈睿,扬凯,等.隐蔽切口、胸锁乳突肌肌瓣改良术式在腮腺区域手术中的临床应用[J].重庆医学,2005,34(3):336-338.
[5]Gainotti G,Cianchetti C,Taramelli M,et al.The guided selfrating anxiety-depression scale for use in clinical psychopharmacology[J].Act Nerv Super(Praha),1972,14(1):49-51.
[6]Zung WW.A self-rating depression scale[J].Arch Gen Psychiatry,1965,12:63-70.
[7]O'Brien CJ.Current management of benign parotid tumors--the role of limited superficial parotidectomy[J].Head Neck,2003,25(11):946-952.
[8]Vieira MB,Maia AF,Ribeiro JC.Randomized prospective study of the validity of the great auricular nerve preservation in parotidectomy[J].Arch Otolaryngol Head Neck Surg,2002,128(10):1 191-1 195.
[9]冉屹东,周彪.改良型腮腺切除术治疗腮腺肿瘤的临床优势评估[J].中国肿瘤临床与康复,2015,22(2):158-160.
[10]郭琦.改良型腮腺切除术与传统切除术治疗腮腺肿瘤的临床治疗效果对比[J].中国实用医药,2014,9(4):32-33.
[11]赵亚东,陈玉友,张硕,等.改良美容切口在腮腺良性肿瘤切除术中的临床应用探讨[J].内蒙古医学杂志,2015,47(12):1 497-1 499.
[12]Roh JL.Extracapsular dissection of benign parotid tumors using a retroauricular hairline incision approach[J].Am J Surg,2009,197(5):e53-e56.