不保留导管的腮腺浅叶切除术后单纯负压加压预防涎瘘的研究(英文)  

The Application of Entire Process Suction Drainage to Prevent Salivary Fistula after Superficial Parotidectomy with Stensen Duct Ligation

作　　者：江瑾[1] 贾暮云[1] 袁荣涛[1] 王科[1] 张奎 卜令学[1] 

机构地区：[1]青岛大学医学院附属医院口腔颌面外科,山东青岛266003 [2]高密市中医院口腔科,山东高密261500

出　　处：《现代生物医学进展》2014年第19期3718-3722,共5页Progress in Modern Biomedicine

基　　金：Science and Technology Development Mentoring Program of Qingdao Municipal(KZD-11)~~

摘　　要：目的：涎瘘为腮腺病变术后常见的并发症，术后放置负压引流结合绷带加压包扎1周或2周时间，已经成为腮腺术后预防涎瘘的常规方法。本研究着重于评价单纯负压引流在腮腺手术后涎瘘预防的临床价值，并根据术后引流量、引流天数与涎瘘的关系，寻找最佳的拔管时机。方法：不保留腮腺导管的腮腺浅叶切除的腮腺疾病病人194例，分为传统加压组（第一组）和单纯负压组（第二组），第一组病人拔除引流管后继续加压包扎，第二组病人拔管后不再加压包扎；记录术后涎瘘情况，对比两组涎瘘率的差异，同时分析单纯负压组引流量、引流天数与术后涎瘘的关系。结果：传统加压组涎瘘率（11．6％）与单纯负压组涎瘘率（15．5％）对比无统计学差异（P〉0．05）；单纯负压组，引流天数与涎瘘率对比无明显相关（P〉0．05），而引流量少于20mL与（20-30）mL对比术后涎瘘率差异显著。结论：单纯负压引流能代替传统拔管后继续加压包扎预防涎瘘，从而避免了因绷带加压包扎引起的诸多并发症；另外，在评估拔管时机时，引流量比引流时间更重要，且引流量小于20mL可作为最佳的拔管时机，这可作为一个指导临床治疗的共识。Objective： Parotid salivary fistula is a common complication after parotidectomy, and suction drainage tube combining with bandaged one or two weeks in the area of parotid lesions, has become the conventional method of preventing parotid salivary fistula. This study focuses on evaluating the clinic application of entire process suction drainage to prevent salivary fistula after parotidectomy, and to select the best time point to remove the drainage according to the drain output and the drain duration. Methods： A cohort of 194 patients with parotid diseases after superficial parotidectomy was assigned into traditional pressure group （Group 1） and entire pro- cess suction group （Group 2）. Pressure dressing was involved after suction drain removed in Group 1, while entire process suction was fixed in Group 2. The relationship of the output, duration and salivary fistula was also analyzed. Results： The traditional occurrence of salivary fistula of the pressure groups was 11.6 %, and the rate of the entire process suction groups was 15.5 %. No statistical significance was found between the two groups （P〉0.05）. In the group 2, significant correlation of the drain duration and salivary fistula was not found （P〉0.05）, however the drain output of （0-20） ml and （20-30） ml resulted in the different rates of the salivary fistula related to post- parotidectomy. Conclusions： According to our findings, the entire process suction used as drainage can be a substitute for the traditional pressure method in preventing the salivary fistula related to postparotidectomy, and this avoids many complications due to the pressure bandage. In addition drainage output at extubation time is more important than drainage duration, and the best time point of drainage extubation referred to drain output less than 20 ml in 24-hour period, which can be used as a consensus to guide clinical treatment.

关 键 词：腮腺浅叶切除术 涎瘘 负压引流 

分 类 号：R782.7[医药卫生—口腔医学]