河北医科大学学报

• 论著 • 上一篇    下一篇

超声刀联合美容切口对腮腺肿瘤手术面神经的保护作用

  

  1. 河北省唐山市人民医院头颈外科,河北 唐山 063000
  • 出版日期:2020-02-25 发布日期:2020-03-13
  • 作者简介:顾占国(1980-),男,河北昌黎人,河北省唐山市人民医院主治医师,医学学士,从事头颈外科疾病诊治研究。

The protective effect of ultrasonic scalpel combined with cosmetic incision on facial nerve in surgery for parotid neoplasms

  1. Department of Head and Neck Surgery, Tangshan People′s Hospital, Hebei Province, Tangshan 063000, China
  • Online:2020-02-25 Published:2020-03-13

摘要: [摘要]
目的 探讨超声刀联合美容切口对腮腺肿瘤手术面神经的保护作用。
方法 将150例腮腺肿瘤患者按随机数字表法分为观察组和对照组各75例。观察组采用超声刀联合美容切口,对照组采用传统电刀联合美容切口。比较2组术中术后指标、面神经肌电图、面神经功能分级、术后并发症及肿瘤复发率。
结果 观察组手术时间、术中出血量、术后引流量、住院时间明显短于或少于对照组(P<0.05)。术后30 d,2组波幅值明显低于术前,神经损伤变性率明显高于术前,差异均有统计学意义(P<0.05);观察组波幅值明显高于对照组,神经损伤变性率明显低于对照组,差异均有统计学意义(P<0.05)。术后30 d,2组面神经功能分级差异无统计学意义(P>0.05)。观察组暂时性面瘫、耳垂麻木发生率明显低于对照组(P<0.05)。
结论 超声刀具有良好止血切割功能,联合美容切口可以减轻腮腺肿瘤切除术中面神经损伤,缩短手术时间,加快患者康复进程。

关键词: 腮腺肿瘤, 美容切口, 超声刀, 面神经

Abstract: [Abstract]Objective To investigate the protective effect of ultrasonic scalpel combined with cosmetic incision on facial nerve in surgery for parotid neoplasms.
Methods One hundred and fifty patients with parotid neoplasms were selected and they were divided into observation group and control group by the random number table method with 75 cases in each group. The observation group was treated with ultrasonic scalpel combined with cosmetic incision, while the control group was treated with traditional electrotome combined with cosmetic incision. The indexes during and after surgery, facial nerve electromyogram, grade of facial nerve function, complications after surgery and tumor recurrence rate were compared between the two groups.
Results The surgical time, intraoperative blood loss, postoperative drainage volume and hospitalization time of the observation group were significantly shorter or less than those of the control group(P<0.05). The wave amplitude in observation group at 30 days after surgery was significantly higher than that in control group while the degeneration rate of nerve injury was significantly lower than that in control group(P<0.05). There was no significant difference in grade of facial nerve function between two groups at 30 days after surgery(P>0.05). The incidence rates of temporary facial paralysis and earlobe numbness in observation group were significantly lower than those in control group(P<0.05).
Conclusion Ultrasonic scalpel has good hemostatic and cutting function. Its combined use with cosmetic incision can reduce the facial nerve injury in resection of parotid neoplasms, shorten the surgical time and accelerate the rehabilitation process.

Key words: parotid neoplasms, cosmetic incision, ultrasonic scalpel, facial nerve