异种脱细胞真皮基质与重建腮腺嚼肌筋膜预防腮腺切除术后味觉出汗综合征的比较研究  

Comparative study of using heterogeneous acellular dermal matrix and reconstruction of parotid masseter faseial in prevention of Frey′s syndrome after parotidectomy

作　　者：赵健[1] 余洪强[1] 刘阿贵[1] 

机构地区：[1]江苏省无锡市第四人民医院口腔科,无锡214062

出　　处：《口腔医学》2011年第6期356-359,共4页Stomatology

摘　　要：目的比较异种脱细胞真皮基质和重建腮腺咬肌筋膜预防腮腺手术后味觉出汗综合征的效果。方法将2005年1月—2008年10月无锡市第四人民医院口腔科收治的腮腺良性肿瘤患者87例,随机分为4组:①对照组(A组)15例,单纯行不保留咬肌筋膜的腮腺肿瘤及浅叶组织切除;②胸锁乳突肌肌瓣组(B组)23例,不保留腮腺嚼肌筋膜的腮腺肿瘤及腮腺组织切除后,缺损处表面覆盖胸锁乳突肌肌瓣。③腮腺咬肌筋膜瓣组(C组)22例,切除腮腺肿瘤及腮腺组织时保留腮腺咬肌筋膜;④异种脱细胞真皮基质组(C组)27例,行不保留咬肌筋膜的腮腺肿瘤及腮腺组织叶切除术后,根据缺损大小植入异种脱细胞真皮基质。结果所有病例术后随访12个月时,进行主观评价及客观评价,A组10/15例(66.67%)、B组4/23例(17.39%)、C组2/22例(9.09%)、D组1/27例(3.70%)出现味觉出汗综合征。D组与C组和第B、A组比较,有显著统计学差异(P<0.05),D组与C组两者之间并无明显统计学差异。结论保留腮腺咬肌筋膜能够预防味觉出汗综合征,对于无法保留腮腺咬肌筋膜者利用异体脱细胞真皮基质也同样能够较好的预防味觉出汗综合征发生。Objective To evaluate the outcome of reconstruction of parotid masseter faseial and heterogeneous acellular dermal matrix（H-ADM） in prvention of Frey′s syndrome after parotidectomy.Methods 87 patients who suffered from benign tumors in the parotid gland and underwent superficial parotidectomy in our hospital from January 2005 to October 2008 were included in this study.15 patients（control group,group A）were treated with superficial parotidectomy without parotid masseter faseial;23 patients（sternocleidomastoid muscle flap group,group B）had parotid masseter fascia unreserved in the parotidectomy and we used sternocleidomastoid muscle flap to repair the tissue defects;22 patients（parotid masseter fascia group,group C） had parotid masseter fascia reserved in the superficial parotidectomy;27 patients（heterogeneous acellular dermal matrix group,group D）,were implanted with heterogeneous acellular dermal matrix in the parotidectomy with parotid masseter fascia unreserved.After a 12 months follow-up,all patients were evaluated via Minor′s iodine-starch test and clinical examination.SPSS 10.0 software package was used for Chi-square test.Results The incidences of Frey′s syndrome were 66.67%（10/15）in group A,17.39%（4/23） in group B、9.09%（2/22） in group C and 3.70%（1/27） in group D.The differences between group D（C）and B、A were statistically significant（P0.05）.But difference between D and C has no statistically significant.Conclusions The Frey′s syndrome can be prevented with parotid masseter fascia reserved in the superficial parotidectomy,but in the cases that parotid masseter fascia can not be reserved,using H-ADM can get the same effect.

关 键 词：异种脱细胞真皮基质 腮腺咬肌筋膜重建 腮腺切除术 味觉出汗综合征 

分 类 号：R782.7[医药卫生—口腔医学]