腮腺浅叶及部分切除术后单纯负压加压预防涎瘘的研究

发布时间：2018-09-12 06:09

【摘要】：目的：涎瘘为腮腺病变术后常见的并发症,术后放置负压引流结合绷带加压包扎1周时间,已经成为腮腺术后预防涎瘘的常规方法。本研究着重于评价在腮腺浅叶及部分切除术中应用单纯负压引流预防涎瘘的临床价值,并根据术后引流量、引流天数与涎瘘的关系,寻找最佳的拔管时机。方法：不保留腮腺导管的腮腺浅叶切除的腮腺疾病病人194例,分为传统加压组(82例)和单纯负压组(112例)：腮腺部分切除术病人103例,传统加压组(50例)和单纯负压组(53例)。传统加压组病人拔除引流管后继续加压包扎,单纯加压组病人拔管后不再加压包扎；记录术后涎瘘情况,分别对比两种术式中两组涎瘘率的差异,同时分析单纯负压组引流量、引流天数与术后涎瘘的关系。结果：两种术式中,传统加压组涎瘘率与单纯负压组涎瘘率对比均无统计学差异(P0.05)；两种术式的单纯负压组,引流天数与涎瘘率对比均无明显相关(P0.05)；对于腮腺浅叶切除术引流量少于20m1与(20-30)ml对比术后涎瘘率差异显著,而腮腺部分切除术中引流量在(0-10)m1与(20～30)ml对比中,差异有统计学意义。结论：单纯负压引流能代替传统拔管后继续加压包扎预防涎瘘,从而避免了因绷带加压包扎引起的诸多并发症：另外,在评估拔管时机时,引流量比引流时间更重要,在腮腺浅叶切除术后,引流量小于20ml可作为最佳的拔管时机；而在腮腺部分切除术,要求引流量小于10ml。预防涎瘘不采用加压包扎,治疗涎瘘采用加压包扎可作为一项共识进行推广。
[Abstract]:Objective: salivary fistula is a common complication after parotid gland disease. It has become a routine method to prevent salivary fistula after parotid gland operation by placing negative pressure drainage and bandage and bandaging for one week. The purpose of this study was to evaluate the clinical value of simple negative pressure drainage in the prevention of salivary fistula in parotid superficial lobectomy and partial resection, and to find the best extubation time according to the relationship between drainage time and salivary fistula. Methods: 194 patients with parotid gland disease were divided into traditional compression group (82 cases) and simple negative pressure group (112 cases): partial parotidectomy group (103 cases), traditional pressure group (50 cases) and simple negative pressure group (53 cases). The patients in the traditional pressure group continued to apply pressure bandage after the drainage tube was removed, and the patients in the simple pressure group did not apply the pressure bandage after the extubation, recorded the situation of postoperative salivary fistula, compared the differences of the two groups in the two kinds of operation methods, and analyzed the drainage rate of the simple negative pressure group. The relationship between drainage days and postoperative salivary fistula. Results: there was no significant difference in the rate of salivary fistula between the traditional pressure group and the simple negative pressure group (P0.05), but there was no significant correlation between the days of drainage and the rate of salivary fistula in the simple negative pressure group (P0.05). For superficial parotid lobectomy, the drainage volume was less than that of 20m1 and (20-30) ml, but the difference was statistically significant between (0-10) M1 and (20 ~ 30) ml in partial parotid resection. Conclusion: the simple negative pressure drainage can replace the traditional pressure bandaging after extubation to prevent the salivary fistula, thus avoiding many complications caused by bandage pressure bandage. In addition, in evaluating the extubation time, the drainage flow is more important than the drainage time. After superficial parotid lobectomy, drainage less than 20ml is the best time for extubation, while for partial parotid resection, drainage is required to be less than 10ml. Prevention of salivary fistula without pressure bandaging, the treatment of salivary fistula with pressure bandaging can be used as a consensus to promote.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.7

【参考文献】