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经耳后发际切口行颈清扫术在口腔癌患者中的应用。

Application of supraomohyoid neck dissection via retroauricular hairline incision in patients with oral cancer.

机构信息

Department of Stomatology, Wuhan No.1 Hospital (Wuhan Hospital of Traditional Chinese & Western Medicine), Wuhan, Hubei, China.

Oral Medical Center, the Third Clinical Medical College of China Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, Hubei, China.

出版信息

Auris Nasus Larynx. 2022 Feb;49(1):126-132. doi: 10.1016/j.anl.2021.06.002. Epub 2021 Jul 3.

Abstract

OBJECTIVE

To explore the application of supraomohyoid neck dissection via retroauricular hairline incision in patients with oral cancer, thereby providing a basis for the surgical treatment of patients with oral cancer in clinical practice.

METHODS

A total of 68 patients with oral cancer who met the inclusion criteria and exclusion criteria were included in our hospital from August 2018 to June 2020. According to the random number table method, they were divided into the experimental group (34 cases), in which patients underwent supraomohyoid neck dissection via retroauricular hairline incision, and control group (34 cases), in which patients received neck dissection.

RESULTS

The operation time was significantly longer and the intraoperative bleeding was significantly less in the experimental group compared with those in the control group (both P < 0.05). No significant differences in postoperative drainage, number of detected lymph nodes and length of hospital stay were detected between the two groups. One month after surgery, the scores of pains, muscle strength, range of motion and daily activities were significantly higher in the experimental group than those in the control group (all P < 0.05). Three months after surgery, the scores of pains, muscle strength, range of motion and daily activities were higher compared with those at one month after surgery in both groups, and these scores in the experimental group were higher than those in the control group (all P < 0.05). In addition, the scores of shoulder function, language, deglutition, chew, work, entertainment, activity of daily living, facial features, pain and degree of satisfaction to the scars in the experimental group were significantly higher than those in the control group one month after surgery (all P < 0.05).

CONCLUSION

Supraomohyoid neck dissection via retroauricular hairline incision can reduce the amount of intraoperative bleeding in patients with oral cancer, is beneficial to the recovery of shoulder joint function, improves the patient's quality of life and the degree of satisfaction to the scars, reduces the occurrence of related complications. It has relatively high safety and is worthy of clinical application and promotion.

摘要

目的

探讨经耳后发际切口行颈清扫术在口腔癌患者中的应用,为临床口腔癌患者的手术治疗提供依据。

方法

选取 2018 年 8 月至 2020 年 6 月我院收治的符合纳入和排除标准的口腔癌患者 68 例,采用随机数字表法分为实验组(34 例)和对照组(34 例),实验组患者采用经耳后发际切口行颈清扫术,对照组患者行颈清扫术。

结果

实验组患者的手术时间明显长于对照组,术中出血量明显少于对照组(均 P<0.05)。两组患者术后引流、检出淋巴结数量及住院时间比较,差异均无统计学意义(均 P>0.05)。术后 1 个月,实验组患者疼痛、肌力、关节活动度和日常生活活动评分均明显高于对照组(均 P<0.05)。术后 3 个月,两组患者疼痛、肌力、关节活动度和日常生活活动评分均高于术后 1 个月,且实验组评分均高于对照组(均 P<0.05)。此外,术后 1 个月实验组患者的肩关节功能、语言、吞咽、咀嚼、工作、娱乐、日常生活活动、面部特征、疼痛及对瘢痕的满意度评分均明显高于对照组(均 P<0.05)。

结论

经耳后发际切口行颈清扫术可减少口腔癌患者术中出血量,有利于肩关节功能恢复,提高患者生活质量和对瘢痕的满意度,减少相关并发症的发生,具有较高的安全性,值得临床应用和推广。

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