270例老年人腮腺沃辛瘤术式的选择与改良  

Selection and improvement of surgical techniques to treat adenolymphoma for 270 elderly patients

作　　者：陈飞[1] 王利伟 布静秋[1] CHEN Fei;WANG Li-wei;BU Jing-qiu(Maxillofacial Surgery Department of the Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心口腔颌面外科,北京100853 [2]解放军总医院第一医学中心口腔科,北京100853

出　　处：《中华老年口腔医学杂志》2022年第3期144-147,共4页Chinese Journal of Geriatric Dentistry

摘　　要：目的:探讨我院10年来270例老年人腮腺沃辛瘤不同术式的选择与改良。方法:回顾分析我院口腔颌面外科近10年老年人腮腺沃辛瘤270例,依据肿瘤发生的部位、数目、是否伴有腮腺组织增生及老年患者的全身状况等因素,分别采用腮腺浅叶切除术、腮腺区域性切除术、沃辛瘤单纯摘除术、及改良的腮腺深叶及肿物切除术四种术式。结果:沃辛瘤位于腮腺浅叶的78例,均行腮腺浅叶切除术,手术效果良好;肿物位于腮腺下极183例,其中行腮腺浅叶切除术73例,行腮腺区域性切除术89例,区域性切除患者中31例伴有腮腺组织增生,术后术区凹陷畸形相对明显,术后复发1例;行单纯肿物切除术21例,其中2例术后复发;肿物位于腮腺深叶9例,其中2例采用腮腺全切除术,术后凹陷畸形明显,7例采用改良的腮腺深叶及肿物切除术,术区未出现凹陷畸形。结论:老年人腮腺沃辛瘤应综合考虑肿瘤的临床特点及老年人的身体状况采用不同的术式,对于发生于腮腺浅叶或伴有腮腺组织增生的尾叶区肿物宜采用腮腺浅叶切除的术式;发生于腮腺深叶的肿瘤,采用改良的腮腺深叶及肿物切除术,保留腮腺浅叶的形态与功能为佳。Objective:To explore the selection and improvement of different surgical methods for 270 elderly patients with adenolymphoma in Chinese PLA General Hospital in the past 10 years.Methods:270 elderly patients with adenolymphoma in the Maxillofacial Surgery Department of the Chinese PLA General Hospital in the past 10 years were retrospectively analyzed.According to the site,number of tumor occurrence,presence of parotid tissue hyperplasia and systemic condition of elderly patients,superficial parotid resection,regional parotid resection,Washoma enucleation,improved deep parotid resection and mass resection were used.Results:78 cases of adenolymphoma located in the superficial lobe of the parotid gland were all treated with superficial parotid lobectomy,and the surgical effect was good;183 cases of tumor located in the lower pole of the parotid gland,73 cases of which were treated with superficial parotidectomy and 89 cases of parotid regional resection.Among the patients with regional resection,31 patients were accompanied by hyperplasia of parotid gland tissue,the postoperative depression deformity was relatively obvious,and 1 patient had recurrence after surgery;21 patients underwent simple tumor resection,of which 2 patients recurred after surgery;the tumor was located in the parotid gland.There were 9 cases of the deep lobe,of which 2 cases were treated with total parotidectomy,and the depression deformity was obvious after the operation.Conclusion:The adenolymphoma in the elderly should consider the clinical characteristics of the tumor and the physical condition of the elderly.For tumors in the superficial lobe of the parotid gland or caudal lobe with hyperplasia of the parotid gland tissue,the superficial parotid lobectomy should be used.For tumors that occur in the deep lobe of the parotid gland,the modified deep lobe and tumor resection should be used to preserve the shape and function of the superficial lobe of the parotid gland.

关 键 词：腮腺 沃辛瘤 浅叶切除 区域性切除术 

分 类 号：R782.05[医药卫生—口腔医学]