内镜辅助下小切口颌下腺切除术的疗效观察  

Clinical Observation of Endoscope Assisted Resection of Submandibular through a Minimally Incision

作　　者：刘冰莲 彭治龙 

机构地区：[1]广东省东莞市大朗医院,广东东莞523770

出　　处：《中国医学创新》2014年第5期126-128,共3页Medical Innovation of China

摘　　要：目的:探讨内镜辅助下小切口的颌下腺切除术的可行性。方法:选取2008年5月-2012年5月就诊于本院的颌下腺良性病变患者12例。设计下颌下区切口,内镜辅助下行颌下腺切除术。先切开颌下腺下缘的包膜,包膜下观察镜下面动脉、颏动脉颌下腺体分支和面前静脉属支的走行特点,采用高频超声刀凝断血管分支和下颌下神经节的腺体分支,结扎颌下腺导管,完整切除腺体。橡皮胶条负压引流,皮内缝合切口。结果:切口长度2.0~2.5 cm,平均(2.3±0.3)cm;手术时间41~87 min,平均(64±20)min;术中出血5~10 mL;术中术后无面瘫、无感染,切口均一期愈合。随访4个月~4年,无复发。与传统切口相比,切口长度明显缩短,出血量明显减少,手术时间稍长。结论:采取小切口的内镜颌下腺切除损伤小,术后能获得良好的美容效果。Objective： To investigate the feasibility of endoscope assisted resection of submandibular gland through a minimally incision. Method： 12 patients diagnosed as benign diseases of submandihular gland from May 2008 to May 2012 in our hospital were chosen. Each l^atient was given a careful design of dermatoglyph incision preoperatively and an endoscope assisted surgery on the submandibuiar gland. The details of surgery procedure were described as follow. The inferior edge of the capsule of the submandibular gland was incised, and the traveling characteristics of facial artery, submandihuar gland branch of submental artery, branches of anterior facial vein were identified with endoscopic assistance. Branches of vascular and submandibular postganglionic fibers were treated with high frequency ultrasound hemostasis. The submandihular duct was identified and isolated, teased downward from the floor of the mouth, and then ligated. The gland was lifted off the digastric tendon and removed. Suction drainage was used with a plastic Drainage strip and the incision was closed with mattress suture. The incision length, intraoperative bleeding. Result： The incision lengths varied from 2.0 - 2.5 cm with an average of 2.3 cm. The operation durations varied from 41 - 87 min, with an average of 64 min. The total intraoperative bleeding was about 5 to 10 ml. No facial paralysis nor infection occurred both intra-and post-operatively. No relapse was detected in the long-term follow-up （ 4 months to 4 years ） . Compared with the traditional group, the incision length and bleeding decreased dramatically while the operational tration increased. Conclusion： Endoscope assisted resection of submandibular gland through a minimally incision will minimize the damage to surrounding tissue and obtain good cosmetic results.

关 键 词：内镜 颌下腺疾病 切除术 

分 类 号：R782.2[医药卫生—口腔医学]