超声骨刀辅助牙龈癌手术治疗的临床应用分析  

Clinical application analysis of the gingival carcinoma surgery with ultrasonic osteotome assistant

作　　者：陈爱和[1] 邓秋明[2] 李惠山[1] 张颖[3] 李会政[3] CHEN Aihe;DENG Qiuming;LI Huishan;ZHANG Ying;LI Huizheng(Department of Stomatology,Dalian Friendship Hospital,Dalian 116001,Liaoning,China;Department of Critical Care Medicine,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,Liaoning,China;Department of Otorhinolaryngology Head and Neck Surgery,Dalian Friendship Hospital,Dalian 116001,Liaoning,China)

机构地区：[1]大连市友谊医院口腔科,辽宁大连116001 [2]大连医科大学附属第一医院重症医学科,辽宁大连116011 [3]大连市友谊医院耳鼻咽喉头颈外科,辽宁大连116001

出　　处：《癌症进展》2020年第21期2216-2219,共4页Oncology Progress

摘　　要：目的探讨超声骨刀在牙龈癌患者颌骨手术中的辅助应用价值。方法按照随机数字表法将52例需行局部颌骨病灶切除术的牙龈癌患者随机分为观察组和对照组,各26例。对照组采用传统颌骨切割器械切除颌骨病灶,观察组采用超声骨刀术式切除颌骨病灶。比较两组患者行局部颌骨病灶切除术中的手术时间、出血情况及术后并发症发生情况。结果观察组患者在局部颌骨病灶切除术中的平均耗时和平均出血量均明显少于对照组患者(P﹤0.05)。术后,对照组患者颌面部疼痛程度为Ⅰ级的患者比例低于观察组,颌面部疼痛程度为Ⅲ级的患者比例高于观察组(P﹤0.05)。术后,对照组患者颌面部肿胀程度为0度和Ⅰ度的患者比例均低于观察组,术后颌面部肿胀程度为Ⅲ度的患者比例高于观察组(P﹤0.05)。术后,对照组患者张口受限程度为0度的患者比例低于观察组,张口受限程度为Ⅲ度的患者比例高于观察组(P﹤0.05)。结论与传统颌骨切割器械相比,在行局部颌骨病灶切除术中,超声骨刀术式的手术时间和术中出血量均较少,能够有效降低牙龈癌患者的治疗痛苦和肿胀程度,且术后并发症发生率较低,安全微创。Objective To investigate the auxiliary application value of ultrasonic osteotome in orthognathic surgery of patients with gingival carcinoma. Method A total of 52 patients with gingival carcinoma received partial jaw resection were randomly divided into observation group and control group with 26 cases in each group according to the random number table method. The control group used traditional jaw cutting instruments to remove the jaw lesions, and the observation group used ultrasonic osteotome to remove the jaw lesions. Indicators including the operation time, bleeding volume and postoperative complications of the two groups of patients during the partial jaw resection were compared.Result The mean value of operation time and blood loss of patients in the observation group during partial jaw resection were significantly less than those in the control group(P<0.05). After surgery, the proportion of patients with grade Ⅰ maxillofacial pain in the control group was lower than that of the observation group, and the proportion of patients with grade Ⅲ was higher than that of the observation group(P<0.05). After the surgery, the proportion of patients in the control group with degree of maxillofacial swelling of grade 0 and Ⅰ was lower than that of the observation group, and the proportion of patients with grade Ⅲ maxillofacial swelling after surgery was higher than that of the observation group(P<0.05).After the surgery, the proportion of patients in the control group with grade 0 mouth opening restriction was lower than that of the observation group, and the proportion of patients with grade Ⅲ was higher than that in the observation group(P<0.05). Conclusion The ultrasonic osteotome has shorter operative time and less intraoperative blood loss during local jaw resection compared with traditional jaw cutting instruments, which can effectively reduce the pain and swelling of patients with gingival cancer, and characterized as safe and minimally invasive based on its low incidence of postoperative complicati

关 键 词：超声骨刀 牙龈癌 颌骨病灶 疼痛 肿胀 

分 类 号：R739.8[医药卫生—肿瘤]