贵州医科大学学报

2015, v.40;No.182(11) 1265-1268

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面神经改良分离剥脱术在腮腺切除中的应用
Application Value of Modified Separation and Stripping of Facial Nerve in the Operation of Parotid Gland Excision

廖壮群;张玉婷;唐超;
LIAO Zhuangqun;ZHANG Yuting;TANG Chao;Department of Stomatology,Xiaolan People's Hospital of Zhongshan City;Department of Ophthalmology and Otorhinolaryngology,Xiaolan People's Hospital of Zhongshan City;

摘要(Abstract):

目的:探讨面神经改良分离剥脱术在腮腺切手术中的的应用。方法:96例腮腺切除患者,采用随机数表法均分为观察组与对照组;对照组接受常规腮腺切除术,术中顺行剥离面神经,观察组在常规腮腺切除术的基础上行改良分离神经剥脱术,比较两组患者术后1、10 d各类并发症发生情况;采用H-B系统评价体系分析两组患者面神经受损情况,检测神经动作电位波幅、潜伏时间和电位持续时间并计算出神经损伤的变性率,进而评估两组患者面神经损伤情况。结果:与对照组比较,观察组患者术后1 d神经动作电位波幅升高、潜伏时间降低(P<0.05),与同组术前比较,观察组患者术后10 d神经损伤变性率、潜伏时间及动作电位持续时间降低、波幅升高(P<0.05),观察组改善效果最为显著;观察组无永久性面神经损伤患者,暂时性面瘫13例,Frey’s综合征7例,并发症发生率明显低于对照组(P<0.05);H-B系统评分观察组优于对照组(P<0.05)。结论:腮腺切除术中行改良分离剥脱术可有效避免手术对面神经的损伤,防治术后面瘫等并发症发生。
Objective: To explore application value of modified separation and stripping of facial nerve in the operation of parotid gland excision. Methods: Ninty-six cases of patients with parotid resection in our hospital from February 2013 to February 2014 were selected as the research objects,who were divided into observation group and control group using a random number table method,48 cases of patients in each group. Control group received conventional parotid resection and intraoperative antegrade stripping of facial nerve while observation group received modified isolation and stripping of facial nerve on the basis of conventional parotid resection. The incidence of complications was compared between the two groups. The H-B system evaluation system was adopted to analyze facial nerve damage and detect nerve action potential amplitude,latency and potential duration. Then degeneration rate of nerve injury in two groups were calculated and assessed. Results: There were statistical differences in nerve action potential amplitude,latency duration between two groups( P < 0. 05) 1 day after surgery.10 days after surgery,the degeneration rate,potential amplitude,latency and potential duration in two groups were improved significantly compared with normal level,and more significant in observation group. The differences showed statistical significance( P < 0. 05). No permanent facial nerve injury was observed in observation group. 13 cases of temporary facial paralysis and 7 cases of Frey 's syndrome were observed in observation group,and the incidence of complications was significantly lower than their counterparts in control group( P < 0. 05). The results of H-B system evaluation showed that in observation group the nerve function recovery was significantly better than that of control group( P <0. 05). Conclusion: The modified separation and stripping of facial nerve in the operation of parotid gland excision can provide adequate protection for the facial nerve in the operation,reduce the damage of the facial nerve,and prevent the postoperative complications.

关键词(KeyWords): 神经剥离;腮腺切除术;神经损伤;术后修复
nerve dissection;parotid gland excision;nerve injury;postoperative repair

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作者(Author): 廖壮群;张玉婷;唐超;
LIAO Zhuangqun;ZHANG Yuting;TANG Chao;Department of Stomatology,Xiaolan People's Hospital of Zhongshan City;Department of Ophthalmology and Otorhinolaryngology,Xiaolan People's Hospital of Zhongshan City;

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DOI: 10.19367/j.cnki.1000-2707.2015.11.037

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