基于ABC分区法的手术入路决策在腮腺内镜手术中的应用  

Applying ABC-partition concept-based operation approaches to endoscopic surgery of parotid gland tumor

作　　者：曹昶 张知妍 何佳潞 陈塑 杨帆[1] 孟沙沙 李岱蔚 董永涛 颜洁 孙艳[4] 朱桂全[1] Cao Chang;Zhang Zhiyan;He Jialu;Chen Su;Yang Fan;Meng Shasha;Li Daiwei;Dong Yongtao;Yan Jie;SunYan;Zhu Guiquan(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;Dept.of Dentistry,the First People’s Hospital of Pingdingshan City,Pingdingshan 467000,China;Dept of Oral and Maxillofacial Surgery,the People’s Hospital of Yuxi City,Yuxi 653100,China;State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Operating Room,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院头颈肿瘤外科,成都610041 [2]平顶山市第一人民医院口腔科,平顶山467000 [3]玉溪市人民医院口腔颌面外科,玉溪653100 [4]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院手术室,成都610041

出　　处：《国际口腔医学杂志》2025年第2期217-230,共14页International Journal of Stomatology

基　　金：四川省中央引导地方科技发展专项(2023ZYD0106)。

摘　　要：目的评估一种基于ABC分区法的手术入路决策,在腮腺肿瘤内镜手术应用中的可行性、安全性及美观效果。方法回顾性纳入2022年1月1日-2024年1月1日于四川大学华西口腔医院头颈肿瘤外科接受免充气内镜下腮腺肿瘤切除术的95例患者。根据是否应用ABC分区法对患者进行分组,统计围手术期及随访数据。结果ABC分区法组患者的手术时间、术中出血量、术后引流量、涎瘘发生率、总住院时间均少于非分区法组,差异均有统计学意义(P<0.05)。非分区法组术后美观效果评价的视觉模拟评分为(1.63±0.88)分,分区法组为(1.35±0.82)分,2组患者的差异无统计学意义(P>0.05),对术后美观效果均较为满意。结论采用ABC分区法匹配相应手术入路,可以提高腮腺肿瘤内镜手术的效率和微创性,加快术后康复,具有良好的安全性和美观效果。Objective This study aimed to evaluate the feasibility,safety,and cosmetic outcomes of operation approaches based on the ABC-partition concept for parotid tumors.Methods A total of 95 patients who underwent gasless endoscopic parotidectomy at the Dept.of Head and Neck Oncology in West China Hospital of Stomatology from January 1,2022,to January 1,2024 were retrospectively included.Patients were divided into two groups based on whether the ABC-partition concept-based operation approaches were used.Perioperative and follow-up data were retrieved and analyzed.Results The ABC group showed significantly better outcomes compared to the non-ABC group(P<0.05)in several areas,including average operation time,intraoperative blood loss,postoperative drainage,incidence of salivary fistula,and length of hospital stay.Both groups reported satisfaction with their cosmetic results,with a visual analogue scale score of 1.63±0.88 for the non-ABC group and 1.35±0.82 for the ABC group(P>0.05).Conclusion This study demonstrated that the ABC-partition approach enhances the efficiency and minimally invasive nature of endoscopic surgery for parotid gland tumors,promotes better recovery after surgery,and provides satisfactory safety and cosmetic results.

关 键 词：分区法 腮腺内镜手术 内镜手术入路 

分 类 号：R739.87[医药卫生—肿瘤]