超声刀与单极电刀在腮腺浅叶切除术中的临床应用比较分析  

Clinical application of harmonic scalpel versus monopolar electrocautery in superficial parotidectomy:A comparative analysis

作　　者：邓廷超 陈睿[1] Deng Tingchao;Chen Rui(Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第一医院口腔颌面外科,重庆400016

出　　处：《重庆医科大学学报》2019年第1期119-122,共4页Journal of Chongqing Medical University

摘　　要：目的:分析超声刀与单极电刀在腮腺浅叶切除术中的优缺点及应用前景。方法:对2016年6月至2017年6月间行腮腺浅叶切除术的患者进行回顾性研究。所有术式均一致并由富有经验的医师完成,根据手术使用的器械不同而分为超声刀组和单极电刀组,收集并记录患者的性别、年龄、病理学诊断、肿瘤直径、手术时间、术中出血量、术后引流量、术后引流时间、术后住院时间、术后面神经功能及术后血肿、涎漏相关数据并对比分析。结果:超声刀组、单极电刀组各纳入24例与25例,其中超声刀组相较单极电刀组的术后引流时间[(3.13±0.90)vs.(3.72±0.79);t=2.460,P=0.018)]、术后住院时间[(5.0±1.10)vs.(5.60±0.76);t=2.221,P=0.031]和术后暂时性面瘫程度(Z=-2.138,P=0.033)均明显降低,差异有统计学意义。超声刀组相较单极电刀组在术中出血量,手术时间,术后引流量及术后涎漏、血肿方面无统计学差异(P>0.05)。结论:超声刀对手术创面邻近组织及面神经的保护相较单极电刀有明显优势,安全可靠,值得推广应用。Objective:To analyze the advantages,disadvantages,and application prospects of harmonic scalpel(HS) and monopolar electrocautery(ME) in superficial parotidectomy. Methods:The clinical data of patients who underwent superficial parotidectomy from June 2016 to June 2017 were retrospectively studied. All surgeries were completed using the same method by experienced surgeons,and the patients were divided into HS group and ME group based on the surgical tool used. Sex,age,pathological diagnosis,tumor diameter,time of operation,intraoperative blood loss,postoperative drainage volume and time,length of postoperative hospital stay,postoperative facial nerve function,and postoperative hematoma and salivary fistula were compared between the two groups. Results:Superficial parotidectomy was performed using HS in 24 patients and ME in 25 patients. Postoperative drainage time(3.13±0.90 vs. 3.72±0.79,t=2.460,P=0.018),length of postoperative hospital stay(5.0±1.10 vs. 5.60±0.76,t=2.221,P=0.031),and degree of postoperative temporary facial paralysis(Z=-2.138,P=0.033) were significantly reduced in the HS group than in the ME group. However,there were no significant differences in intraoperative blood loss,time of operation,postoperative drainage volume,and postoperative hematoma and salivary fistula between the two groups(all P >0.05). Conclusion:HS is a safe and reliable tool that provides superior protection of the facial nerves and the tissues near the surgical wound to ME during superficial parotidectomy,and should therefore be widely promoted for clinical application.

关 键 词：超声刀 单极电刀 腮腺浅叶切除术 面瘫 腮腺良性肿瘤 

分 类 号：R782.7[医药卫生—口腔医学]