两种入路摘除咽旁间隙肿瘤临床研究  

Clinical Research of Two Transcervical Approaches of Surgical Treatment of Parapharyngeal Space Tumor

作　　者：罗兴谷 江青山[1] 廖剑绚[1] 卢永田[2] LUO Xing -- gu JIANG Qing -shan LIAO Jian - xuan et al(Department of Otorhinolaryngology, The First Affiliated Hospital of Nanhua University of South China, Hengyang, Hunan, 421001, China)

机构地区：[1]南华大学附属第一医院耳鼻咽喉科,湖南衡阳421001 [2]深圳市第二人民医院耳鼻咽喉科,广东深圳518035

出　　处：《黑龙江医学》2016年第11期994-996,共3页Heilongjiang Medical Journal

摘　　要：目的比较内镜辅助口内入路与颈部入路摘除咽旁间隙肿瘤的疗效,探讨内镜辅助口内入路的适应症、优点和手术技巧。方法回顾性分析深圳市第二人民医院耳鼻咽喉科2012-01—2015-06间收治的23例咽旁间隙肿瘤患者病历资料,根据肿瘤的位置、肿瘤与周围重要结构的关系,分成观察组7例（采用内镜辅助口内入路）和对照组16例（采用经颈部入路）。比较两组患者的手术时间、术中出血量、住院时间,并行统计学分析。结果观察组手术时间（127.00±9.08）min,术中出血（86.00±12.94）m L,住院时间（5.80±0.84）d;对照组手术时间（128.00±11.46）min,术中出血（235.67±15.80）m L,住院时间（9.07±0.88）d。两组患者肿瘤均完全切除,均未出现严重并发症,所有患者术后随访0.5~3年均无复发。观察组与对照组手术时间差异无统计学意义（P〉0.05）;术中出血量、住院时间差异有统计学意义（P〈0.05）。结论内镜辅助口内入路较颈部入路在减少术中出血、缩短住院时间方面有明显优势。内镜辅助口内入路最大的优点是能保存颜面部美观,适用于位于颈动脉鞘内侧及前内侧良性肿瘤的摘除。Objective To compare the curative effect difference between the endoscopy- assisted transoral approach and the transcervical approach of surgical treatment of parapharyngeal space tumors,and to analyze the indication,advantages and surgical skills of the endoscopy- assisted transoral approach. Methods Retrospective analysis was carried out in 23 patients with parapharyngeal space tumor treated in Shenzhen No. 2 People＇s Hospital from January,2012 to June,2015. 23 patients were divided into the observation group and the control group according to the tumors location,and the relationship between PPS neoplasm and adjacent structures. In the observation group,the tumors of 7 cases were removed solely by transoral approach under the guidance of endoscopes,while in the control group,the neoplasms of 16 patients were excised completely through using a transcervical approach. The operation time,blood loss,hospitalization time between the two groups were compared. Results In the observation group,the operation time,the blood loss and the hospitalization time were（ 127. 00 ± 9. 08） minutes,（ 86. 00 ± 12. 94） milliliter,（ 5. 80 ± 0. 84） days respectively. While in the control group,the operation time,the blood loss and the hospitalized time were（ 128. 00 ± 11. 46） minutes,（ 235. 67 ± 15. 80） milliliter,（ 9. 07 ± 0. 88） days respectively.All the neoplasms were completely cut. Patients were followed up for 6 months to 3 years with no recurrence. Through comparing the operation time between the two groups,there was no significant difference. The differences in blood loss,hospitalized time had statistical significance（ P〈 0. 05） between the two groups. Conclusion The endoscopy- assisted transoral approach has significantly shorter hospitalization time and less blood loss than the transcervical approach. One of the biggest advantages of the endoscopy- assisted transoral approach is the ability to maintain facial cosmetic. The endoscopy- assisted transoral approach is a useful technique for t

关 键 词：咽旁间隙肿瘤 内镜辅助口内入路 颈部入路 

分 类 号：R730.5[医药卫生—肿瘤]