超声刀在颈淋巴清扫术中的临床应用  

Neck Dissection Using the Harmonic Scalpel: Retrospective Analysis of 432 Consecutive Cases

作　　者：叶茂昌[1] 王来平[1] 李容新[1] 周瑜[1] 王祎[1] 朱伟政[1] 左雁[1] 

机构地区：[1]安徽医科大学附属省立医院口腔颌面外科,安徽合肥230001

出　　处：《口腔颌面外科杂志》2014年第1期35-38,共4页Journal of Oral and Maxillofacial Surgery

摘　　要：目的 :探讨超声刀技术在口腔颌面头颈部鳞癌施行颈淋巴清扫术中的临床应用价值和手术技巧。方法 :2007-02—2012-12期间,随机交叉选取口腔黏膜鳞状细胞癌432例患者,分为超声刀组(216例)和电刀组(216例)。比较2组的手术时间、失血量、术后24h引流量、术后住院天数以及术后并发症的发生等项目。结果:与电刀组相比较,超声刀组在手术时间、术中失血量、24h引流量、住院天数等方面具有明显优势,经统计学分析,P<0.05为差异有统计学意义。结论:应用超声刀技术施行颈淋巴清扫术,具有传统高频电刀所不具有的组织分离和切割、凝固止血三种功能合一体的优点,实用手术技巧与超声刀技术联合应用,可使颈淋巴清扫完全达到根治性要求。是一种值得临床推广,且有应用前景的颈淋巴清扫治疗策略。Objective： To discuss the clinical value and operation skills for neck dissection in head and neck squamous cell carcinoma using harmonic scalpel. Methods： Eligible 432 cases of oral squamous cell carcinoma performed neck dissection during February 2005 to December 2012, were comprised in this retrospective analysis. Group A were 216 cases using the ultracision harmonic scalpel, while group B were 215 cases using the electric knife. The operation time, intraoperative bleeding volume, postoperative drainage volume within 24 h, postoperative hospital days and postoperative complications between two groups were compared. Results： Group A was demonstrated distinct advantage in operation time, intraoperative bleeding volume, postoperative drainage volume in 24 h and days of hospitalization. There was statistical significance （P〈0.05）. Conclusion： Harmonic scalpel is a quite new technology which can be applied related tissue separation, cutting, and hemostasis three steps together. Harmonic scalpel with skillful techniques demonstrated clinical benefits in neck dissection.

关 键 词：超声刀 颈淋巴清扫 口腔黏膜鳞状细胞癌 

分 类 号：R739.85[医药卫生—肿瘤]