腮腺多形性腺瘤外科术式的演变及发展

发布时间：2018-07-03 03:11

本文选题：多形性腺瘤 + 手术方式　；参考：《中国肿瘤临床》2014年09期

【摘要】：腮腺肿瘤以多形性腺瘤居多,目前外科治疗仍是主要的治疗方式。20世纪时学者们由于对面神经解剖和多形性腺瘤包膜病理特性缺乏了解,该病的主要术式为单纯肿瘤剜除术,但术后容易导致复发;试图通过扩大切除的范围控制复发率,于是包膜外切除术开始运用于临床,虽然切除了肿瘤的包膜,但是复发率仍未能很好地控制。腮腺浅叶切除术和腮腺全切术明显降低了复发率,但是伴随着面神经损伤的加重,似乎又矫枉过正。腮腺部分切除术作为新的腮腺手术形式,不但降低了复发率、面神经损伤率,还得到病理学基础研究证据的支持,是目前较为先进的手术方式。但是在经典的腮腺浅叶切除术与先进的腮腺部分切除术之间仍存在争议。经过整形学、病理学、基因检测法等方面探究这两种手术的优劣均各有差异。本文从腮腺术式的演变历程探讨腮腺术式发展的方向。
[Abstract]:The majority of parotid tumors are pleomorphic adenomas. At present, surgical treatment is still the main way of treatment. In the 20th century, due to the lack of understanding of facial nerve anatomy and the pathological characteristics of pleomorphic adenoma capsule, the main surgical method of parotid adenoma is simple enucleation of tumor. But it is easy to lead to recurrence after operation, and attempts to control the recurrence rate by expanding the scope of resection, so extracapsular resection began to be used in clinical practice. Although the tumor capsule is removed, the recurrence rate is still not well controlled. Superficial parotid lobectomy and total parotidectomy significantly reduced the recurrence rate, but accompanied by the aggravation of facial nerve injury, seems to overdo. Partial parotidectomy, as a new form of parotid surgery, not only reduces the recurrence rate and facial nerve injury rate, but also is supported by the evidence of pathological basic research. But there is still controversy between classic superficial parotid lobectomy and advanced parotid partial resection. Through plastic surgery, pathology, gene detection and other aspects to explore the advantages and disadvantages of the two operations are different. This paper discusses the development direction of parotid gland operation from the evolution of parotid gland operation.
【作者单位】：广西医科大学研究生学院;四川省肿瘤医院头颈外科;
【基金】：国家自然科学基金项目(编号：81302375) 四川省科技厅计划项目(编号：2012JY0125) 四川省卫生厅科研项目(编号：130230，，110259)资助~~
【分类号】：R739.8

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