同期双侧颈清扫在头颈部恶性肿瘤治疗中的应用  

The clinical research of primary bilateral neck dissection in the head and neck tumors

作　　者：王鹏举[1] 柯赛雄[1] 刘灵文[1] 余晔[1] 

机构地区：[1]襄阳市中心医院耳鼻咽喉科,湖北襄阳441021

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第6期255-257,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨头颈部恶性肿瘤行原发灶切除加同期双侧颈清扫的安全性、适应证及手术难点。方法:回顾分析1998-01-2007-12间134例行肿瘤原发灶切除加双侧颈清扫术头颈部恶性肿瘤患者的临床资料,同期双侧颈清扫术方式分为:一侧根治性颈清扫加一侧功能性颈清扫(29例),一侧根治性颈清扫加一侧侧颈清扫(34例),双侧功能性颈清扫(14例),一侧功能性颈清扫例加一侧侧颈清扫(48例),双侧颈侧清扫6例。结果:134例患者无一例手术死亡,并发症为创口出血3例,乳糜漏4例,咽瘘8例,咽瘘伴颈部清扫区感染1例,消化道应激性溃疡5例,其中1例抢救无效死亡,脑梗塞1例。结论:头颈部恶性肿瘤行同期双侧颈清扫是安全的,但要选择适当的清扫方式,以降低颈部淋巴结转移,减轻患者痛苦。Objective：To explore the head and neck tumors underwent primary tumor resection and bilateral neck dissection in the same period in the safety,indications,and surgical difficulty.Method：Retrospective analysis of 134 cases receipted primary tumor resection and bilateral neck dissection for head and neck cancer,the way of bilateral neck dissection were： one side was radical neck dissection and another was functional neck dissection（29 cases）,one side was radical neck dissection and another was lateral neck dissection（34 cases）,bilateral functional neck dissection（14 cases）,one side was functional neck dissection and another was lateral neck dissection（48 cases）,bilateral sides of lateral neck dissection（6 cases）.Result：There was no operative death in 134cases,complications for the wound bleeding in 3 cases,chylous leakage in 4 cases,pharyngeal fistula and infection in 1 case,stress ulcer in 5 cases,1 case died,cerebral infarction in 1 case.Conclusion：The head and neck tumors underwent simultaneous bilateral neck dissection is safe.Appropriate cleaning method selection to reduce cervical lymph node metastasis could reduce the suffering of patients.

关 键 词：头颈肿瘤 颈淋巴结清扫术 淋巴结转移 

分 类 号：R739.91[医药卫生—肿瘤]