不同手术进路方式在口腔癌手术患者中的应用效果及安全性  

Application effect and safety of different surgical approaches in patients with oral cancer surgery

作　　者：王伟新[1] 杨建斌[1] 邵月保[1] WANG Weixin;YANG Jianbin;SHAO Yuebao(Department of Stomatology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,He’nan,China)

机构地区：[1]新乡医学院第一附属医院口腔科,河南卫辉4531000

出　　处：《癌症进展》2022年第7期705-708,共4页Oncology Progress

摘　　要：目的探讨下颌骨舌侧松解进路手术与下唇或下颌骨切开进路手术治疗口腔癌的效果及安全性。方法根据手术进路方式的不同将152例口腔癌患者分为传统组(n=89)和观察组(n=63),传统组患者给予下唇或下颌骨切开进路手术,观察组患者给予下颌骨舌侧松解进路手术。比较两组患者围手术期指标、生活质量[华盛顿大学头颈肿瘤生活质量量表(UW-QOL)]、吞咽功能(洼田饮水试验)、并发症发生情况、术后1年生存率及肿瘤转移率。结果观察组患者的麻醉时间明显长于传统组(P﹤0.01);但两组患者的术中出血量、住院天数均无明显差异(P﹥0.05)。术后6个月,两组患者UW-QOL量表各维度评分均高于本组术前(P﹤0.05),且观察组患者疼痛、面容外形、咀嚼、吞咽、情绪、焦虑、自评生活质量评分均高于传统组(P﹤0.05)。两组患者的洼田饮水试验结果无明显差异(P﹥0.05),观察组患者的并发症总发生率、1年生存率、肿瘤转移率比较,差异均无统计学意义(P﹥0.05)。结论与下唇或下颌骨切开进路手术相比,下颌骨舌侧松解进路手术治疗口腔癌更符合无瘤原则,更有利于改善患者的术后生活质量,安全有效。Objective To investigate the efficacy and safety of mandibular lingual release approach and lower lip or mandibular incision approach in the treatment of oral cancer.Method A total of 152 patients with oral cancer were divided into traditional group(n=89)and observation group(n=63)according to varying surgical approaches.The patients in the traditional group were given the lower lip or mandibular incision approach,and the patients in the observation group were given the mandibular lingual releasing approach.The perioperative indicators,quality of life[university of Washington quality of life questionnaire(UW-QOL)],swallowing function(Kawada drinking test),complications,1-year postoperative survival rate,and tumor metastasis were compared between the two groups of patients.Result The anesthesia time of the observation group was significantly longer than traditional group(P<0.01);however,there were no significant differences in intraoperative blood loss volume and hospital stay between the two groups(P>0.05).Six months after the operation,the scores of each dimension of the UW-QOL scale in the two groups were higher than those before the operation(P<0.05),and the scores of pain,facial appearance,chewing,swallowing,emotion,anxiety,and self-assessed quality of life in the observation group were higher than those in the traditional group(P<0.05).There was no significant difference in the Kawada drinking test between the two groups(P>0.05),and there were no significant differences in the total incidence of complications,1-year survival rate,and metastasis rate in the observation group(P>0.05).Conclusion Compared with the lower lip or mandibular incision approach,the mandibular lingual release approach for the treatment of oral cancer is more in line with the principle of no tumor,and is more conducive to improving the postoperative quality of life of patients.It is safe and effective.

关 键 词：口腔癌 下唇切开进路 下颌骨切开进路 下颌骨舌侧松解进路 

分 类 号：R739.85[医药卫生—肿瘤]