区域性切除手术治疗腮腺混合瘤对患者面部神经和肌肉功能的影响  

Effect of regional resection on facial nerve and muscle function in patients with mixed tumor of parotid

作　　者：吕大为 朱浩 向媛媛 张力 LYU Da-wei;ZHU Hao;XIANG Yuan-yuan(Department of Maxillofacial Surgery,Chinese People's Liberation Army Northern Theater Command General Hospital,Shenyang Liaoning 110000,China)

机构地区：[1]中国人民解放军北部战区总医院颌面外科,辽宁沈阳110000

出　　处：《临床和实验医学杂志》2024年第3期305-309,共5页Journal of Clinical and Experimental Medicine

基　　金：辽宁省医学自然科学基金研究计划(编号:20180510682)。

摘　　要：目的 探究区域性切除手术治疗腮腺混合瘤对患者面部神经和肌肉功能的影响情况。方法 前瞻性选取2020年3月至2022年3月在中国人民解放军北部战区总医院接受治疗的113例腮腺混合瘤患者为研究对象,按照随机数字表法将其分为对照组(n=56)和研究组(n=57)。对照组患者采用传统全腮腺切除术,研究组患者采用区域性切除术。比较两组患者临床指标(手术时间、术中出血量、切口长度、解剖面神经分支数)、术后面神经损伤情况、术后面部肌肉情况、腮腺分泌功能情况及不良反应发生情况。结果 研究组的手术时间、术中出血量、切口长度、解剖面神经分支数分别为(109.26±23.48) min、(52.16±5.98) mL、(9.41±2.49) cm、(2.19±0.35)支,均低于对照组[(146.06±23.15) min、(72.55±7.04) mL、(14.26±3.16) cm、(4.21±0.63)支],差异均有统计学意义(P<0.05)。研究组面神经颧支、颊支、下颌缘支功能损伤的发生率分别为5.26%、7.02%、8.77%,均低于对照组(57.14%、64.29%、98.21%),House-Back-mann面神经损伤分级评分为(1.78±0.66)分,低于对照组[(2.67±0.78)分],Portmann评分为(17.88±2.63)分,高于对照组[(13.65±3.15)分],差异均有统计学意义(P<0.05)。术前及术后3个月时,两组组间腮腺分泌功能比较,差异无统计学意义(P>0.05),术后6、12个月时,研究组患健侧腮腺分泌差值分别为15.59±5.11、16.02±5.46,均低于对照组(38.21±3.16、36.46±4.15),差异均有统计学意义(P<0.05)。研究组皮下积液、Frey综合征、面瘫及面部畸形的发生率分别为3.51%、10.53%、7.02%、7.02%,均低于对照组(21.43%、32.14%、26.79%、28.59%),差异均有统计学意义(P<0.05)。结论 区域性切除手术对腮腺混合瘤患者具有一定的优势,可以降低面部神经和肌肉功能损伤的风险,同时可以减少对腮腺功能的损害,降低并发症发生情况。Objective To explore the effect of regional resection on facial nerve and muscle function in patients with mixed parotid gland tumor.Methods A total of 113 patients with mixed parotid gland tumors who received treatment at the Chinese People's Liberation Army Northern Theater Command General Hospital from March 2020 to March 2022 were prospectively selected as the study subjects.They were randomly divided into the control group(n=56) and the study group(n=57) according to the random number table method.The control group patients underwent traditional total parotidectomy,while the study group patients underwent regional parotidectomy.Clinical indicators(operative time,intraoperative blood loss,incision length and number of anatomic facial nerve branches),postoperative facial nerve injury,postoperative facial muscle,parotidectomy function and adverse reaction were compared between the two groups.Results The operative time,intraoperative blood loss,incision length and number of anatomic facial nerve branches in the study group were(109.26±23.48) min,(52.16±5.98) mL,(9.41±2.49) cm,and(2.19±0.35) branches,respectively,which were lower than those in the control group [(146.06±23.15) min,(72.55±7.04) mL,(14.26±3.16) cm,and(4.21±0.63) branches],and the differences were statistically significant(P<0.05).The incidences of functional damage to the zygomatic,buccal,and mandibular marginal branches of the facial nerve in the study group were 5.26%,7.02%,and 8.77%,respectively,which were lower than those in the control group(57.14%,64.29%,and 98.21%),the House-Back-mann facial nerve injury grading score was(1.78±0.66) points,which was lower than that in the control group[(2.67±0.78) points)],and the Portmann score was(17.88±2.63) points,which was higher than that in the control group[(13.65±3.15) points],the differences were statistically significant(P<0.05).There was no difference in parotid secretion function between the two groups before and 3 months after surgery(P>0.05),the difference in parotid secretion of t

关 键 词：腮腺混合瘤 区域性切除 全腮腺切除术 面部神经功能 

分 类 号：R739.87[医药卫生—肿瘤]