口底区域淋巴组织清扫术在舌癌根治术中的应用效果  

Effect of lymphoid tissue radical dissection of the floor of the mouth in tongue cancer radical surgery

作　　者：董稳航 康鹏 安小宁 Dong Wenhang;Kang Peng;An Xiaoning(Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,郑州450052

出　　处：《中国实用医刊》2025年第3期25-28,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究口底区域淋巴组织清扫术在舌癌根治术中的应用效果。方法队列研究。抽取2020年3月至2023年4月郑州大学第一附属医院收治的舌癌患者77例,采用随机数字表法分为对照组(38例)与研究组(39例)。两组患者均接受舌颌颈联合根治术,研究组在手术中通过颏孔前断离并外展下颌骨,对口底区域淋巴组织进行彻底清扫,对照组则在手术中保留口底区域淋巴组织或未进行彻底清扫。观察并比较两组术前和术后1年的生活质量[华盛顿大学生活质量量表(UW-QOL)评分],并统计术后并发症发生情况。两组术后均随访1年,记录颈部淋巴结转移率、复发率及生存率。结果研究组术后并发症总发生率(15.38%,6/39)与对照组(7.89%,3/38)比较差异未见统计学意义(P>0.05)。术后1年,两组UW-QOL评分均高于术前,且研究组UW-QOL评分高于对照组(P<0.05)。术后随访1年,研究组总复发率(2.56%,1/39)低于对照组(15.79%,6/38),P<0.05;研究组生存率(97.44%,38/39)与对照组(94.74%,36/38)比较差异未见统计学意义(P>0.05)。结论口底区域淋巴组织清扫术在舌癌根治术中具有良好的应用效果,能够有效降低肿瘤的复发率,并在随访期间可提高患者的生活质量,安全性好。Objective To investigate the application effect of lymphoid tissue dissection of the floor of the mouth in the radical resection of tongue cancer.MethodsSeventy-seven patients admitted to the First Affiliated Hospital of Zhengzhou University from March 2020 to April 2023 were selected for the cohort study.And they were divided into the control group(38 cases)and the study group(39 cases)using a random number table method.Both groups received tongue-mandible-neck radical surgery;in the study group,the mandible was split and swung through mental foramen,and lymphoid tissue of the floor of the mouth was radically dissected.In the control group,the lymphoid tissue of the floor of the mouth was preserved or dissected partially.The quality of life assessed by University of Washington-quality of life(UW-QOL)of the two groups before and 1 year after surgery were observed and compared.Moreover,the postoperative complications of the two groups were recorded.Both groups were followed up for 1 year after surgery to record cervical lymph node metastasis rate,recurrence rate and survival rate.ResultsThere was no significant difference in the total incidence of postoperative complications between the study group(15.38%,6/39)and the control group(7.89%,3/38),P>0.05.One year after operation,the UW-QOL scores of the two groups increased,and the study group had higher UW-QOL score than the control group(P<0.05).After 1 year of follow-up,the total recurrence rate of the study group(2.56%,1/39)was lower than that of the control group(15.79%,6/38),P<0.05;while there was no significant difference in the survival rate between the study group(97.44%,38/39)and the control group(94.74%,36/38),P>0.05.ConclusionsLymphoid tissue radical dissection of the floor of the mouth has ideal effect in tongue cancer radical surgery,which can effectively reduce the tumor recurrence rate and significantly improve the quality of life of patients during the follow-up period,with great safety.

关 键 词：舌癌 口底区域淋巴组织清扫术 生活质量 复发 

分 类 号：R739.8[医药卫生—肿瘤]