保留颈外静脉,耳大神经和颈神经丛深支的根治性颈清扫术疗效评价  

Efficiency Evaluation of the of a Modified Radical Neck Dissection Preserving the External Jugular Vein,Greater Auricular Nerve and Deep Branches of the Cervical Nerve

作　　者：李雅冬[1] 杨凯[1] 张劲松[1] 张福军[1] 陈睿[1] 

机构地区：[1]重庆医科大学附属第一医院口腔颌面外科,重庆400016

出　　处：《口腔医学研究》2009年第3期322-324,共3页Journal of Oral Science Research

摘　　要：目的:评价保留颈外静脉,耳大神经和颈神经丛深支的根治性颈清扫术疗效。方法:2001年6月至2003年12月住院的口腔癌初诊患者40例,均经病理确诊,其中男23例,女17例,年龄31～60岁,平均年龄48岁,中位年龄50岁,舌癌16例,颊癌15例,口底癌5例,下牙龈癌4例。所有患者分为两组,分别行经典的根治性颈淋巴清扫术和保留颈外静脉,耳大神经和颈神经丛深支的根治性颈清扫术。结果:术后切口均Ⅰ期愈合,与经典的根治性颈淋巴清扫术相比,保留颈外静脉,耳大神经和颈神经丛深支的根治性颈清扫术在功能保留方面明显优于经典的根治性颈淋巴清扫术(P<0.05),而术后颈部复发率与经典的根治性颈淋巴清扫术无显著差异。结论:保留颈外静脉,耳大神经和颈神经丛深支的根治性颈清扫术可作为口腔癌颈清扫术的常规术式,并易于临床推广。Objective： To evaluate the efficiency of a modified radical neck dissection preserving the external jugular vein, greater auricular nerve and deep branches of the cervical nerve. Methods： From 2001 to 2003, we had treated 40 pa- tients with oral cancer,including 23 female and 17 male. The ages of the patients were from 31 to 60. The average age was 48. The median age was 50. The patients included 16 tongue cancer patients, 15 cheek cancer patients,5 oral bottom cancer patients and 4 gum cancer patients. The patients were randomly divided into two grougs, underwent classic radical neck dis- section and a modified radical neck dissection preserving the external jugular vein, greater auricular nerve and deep bran- ches of the cervical nerve. Results： All the incisions healed well. Compared with classic radical neck dissection group, a modified radical neck dissection preserving the external jugular vein, greater auricular nerve and deep branches of the cervi- cal nerve had less postoperative reactions and better shoulder function （P 〈 0.05）. The recurrence rates had no significant difference between the two groups. Conclusion： For patients with oral carcinoma, a modified radical neck dissection pre- serving the external jugular vein, greater auricular nerve and deep branches of the cervical nerve could be used as an radical modality and suitable to popularize.

关 键 词：根治性颈淋巴清扫术 口腔癌 改良术式 

分 类 号：R739.8[医药卫生—肿瘤]