摘要
目的将腮腺浅叶切除手术耳周V形切口与传统Blair切口及发际线N形切口进行对比,探讨耳周V形切口的可行性。方法对2015年1月至2016年1月就诊于中南大学湘雅二医院,需行腮腺浅叶部分切除手术的60例符合入组标准的患者,其中男47例,女13例,年龄25~63岁,通过抽签随机分为3组:V形切口组(VI组20例)、Blair切口组(BI组20例)和发际线N形切口组(NI组20例)。比较3组在术中、术后及随访各项指标上是否有差异,并比较VI组内不同位置肿瘤的手术时间、引流量是否有差异。采用SPSS 18.0软件进行统计学分析。结果在手术操作时间、引流量、术后住院时间、耳周麻木感、腮瘘、疼痛评分、面瘫、术后第3个月伤口瘢痕评分方面,3组切口差异均无统计学意义(P值均>0.05)。在术后第6个月外观满意度评分方面,VI组优于BI组及NI组,差异有统计学意义(VI组比BI组:9.00[8.00, 9.00]比5.00[4.00, 5.25],χ^2=6.629,P<0.001;VI组比NI组:9.00[8.00, 9.00]比7.00[6.00, 8.00],χ^2=2.942,P=0.010;BI组比NI组:5.00[4.00, 5.25]比7.00[6.00, 8.00],χ^2=-3.687,P=0.001)。位于腮腺前、上、中部的肿瘤中,3组不同切口的手术时间、引流量差异均无统计学意义(P值均>0.05)。位于腮腺下部的肿瘤,3组切口所需要手术时间的差异有统计学意义(F=7.278,P=0.010),经过两两比较,VI组所需要的手术时间多于BI组及NI组,差异有统计学意义[VI组比BI组:(181.00±22.89) min比(132.50±9.01) min,t=3.694,P=0.004;VI组比NI组:(181.00±22.89) min比(149.00±15.94) min,t=2.585,P=0.025;BI组比NI组:(132.50±9.01) min比(149.00±15.94) min,t=1.257,P=0.235]。位于腮腺下部肿瘤的引流量3组比较差异无统计学意义(P>0.05)。VI组内比较不同位置肿瘤手术时间及引流量差异均无统计学意义(P值均>0.05)。结论在腮腺良性肿瘤手术中应用V形切口,仅位于腮腺下部的肿瘤手术时间会延长。对于不同部位的肿瘤均不增加手术并发症,能达到更好的美容效果。
Objective To evaluate the feasibility and efficacy of partial superficial parotidectomy with V-shaped incision by comparing with the Blair incision and hairline N-shaped incision.Methods From January 2015 to January 2016,60 patients(47 males and 13 females,with an age range of 25-63 years)required for superficial partial parotid gland resection were randomly divided into three groups:V-shaped incision(VI)group,Blair incision(BI)group and hairline N-shaped incision(NI)group,with 20 cases in each group.Intraoperative,postoperative and follow-up indexes were compared between three groups.Operative time and drainage volume in the surgery of tumors at different sites in VI group were compared.SPSS18.0 software was used for statistic analysis.Results There were no statistically significant differences among the three groups in operative time,drainage volume,postoperative hospital stay,periauricular numbness,fistulas,pain score,facial palsy,and scar score at the 3rd month after surgery(P>0.05).For appearance satisfaction score at the 6th month after surgery,VI group was better than BI group or NI group,with significant differences(VI group vs.BI group:9.00[8.00,9.00]vs.5.00[4.00,5.25],χ^2=6.629,P<0.001;VI group vs.NI group:9.00[8.00,9.00]vs.7.00[6.00,8.00],χ^2=2.942,P=0.010;BI group vs.NI group:5.00[4.00,5.25]vs.7.00[6.00,8.00],χ^2=-3.687,P=0.001).For tumors located in the front,upper and middle of parotid gland,there were no statistically significant differences in operative time and drainage volume between the three groups(P>0.05).For tumors located at the lower part of parotid gland,the difference in operative time between the three groups was statistically significant(F=7.278,P=0.01).With pairwise comparison,operative time in VI group was longer than that in BI group or NI group,but there was no significant difference between BI group and NI group(VI group vs.BI group:(181.00±22.89)min vs.(132.50±9.01)min,t=3.694,P=0.004;VI group vs.NI group:(181.00±22.89)min vs.(149.00±15.94)min,t=2.585,P=0.025;BIgroup vs.NI group,(132.50±9.01)min vs.(149.00±15.94)min,t=1.257,P=0.235).For tumors located at the lower part of parotid gland,the differences in intraoperative drainage volume were not statistically significant between three groups(P>0.05).There were no statistically significant differences in operative time and drainage volume in the surgery of tumors at different sites in VI group(P>0.05).Conclusions By use of V-shaped incision for the surgery of benign parotid gland tumors,the operation time of tumors located only in the lower part of the parotid gland will be prolonged.For tumors in different sites without increasing surgical complications,this modality can get good cosmetic effect.
作者
李蒙蒙
李仕晟
唐青来
杨新明
贺湘波
Li Mengmeng;Li Shisheng;Tang Qinglai;Yang Xinming;He Xiangbo(Department of Otorhinolaryngology Head and Neck Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2020年第7期658-663,共6页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
腮腺肿瘤
外科手术
手术切口
V形切口
Parotid neoplasms
Surgical procedures
operative
Surgical incision
V-shaped incision
