脱细胞真皮基质预防腮腺术后Frey综合征临床疗效的回顾性研究

发布时间：2018-10-23 19:35

【摘要】：目的：评估脱细胞异体真皮基质(ADM)对预防腮腺术后出现Frey综合征的临床疗效。方法：2005～2010年于山东省立医院口腔颌面外科行腮腺良性肿瘤摘除术且拥有完整回访资料的患者共161例。将这161名患者设为回顾性研究对象,常规手术组(n=87)：按常规行腮腺浅叶、腮腺部分或腮腺全叶摘除术,不植入任何填充材料；植入组织补片组(n=74)：在行腮腺浅叶、腮腺部分或腮腺全叶摘除术后,根据缺损面积大小在剩余腮腺组织及腮腺咬肌筋膜皮瓣之间植入ADM。所有患者均通过问卷调查的方式对Frey综合征发生情况进行主观评估；同时于每组中各随机抽取40名患者行Minor碘-淀粉实验进行客观评估。应用SPSS19.0软件对两组实验数据差异性行卡方检验。结果：根据问卷调查结果显示,常规手术组87名患者中,有36名患者(41.38%)出现Frey综合征的主观症状,植入组织补片组74名患者中,有15名患者(20.27%)出现Frey综合征的主观症状,行卡方检验,χ2=8.23,P0.05,具有统计学意义；根据Minor碘-淀粉实验结果显示：常规手术组40名患者中,有21名患者(52.5%)出现Frey综合征的客观症状,植入组织补片组,有10名患者(25.0%)出现Frey综合征的客观症状,行卡方检验,χ2=6.36,P0.05,具有统计学意义。同时我们将腮腺摘除部位及大小对腮腺术后出现Frey综合征的影响进行了统计学研究,无论是常规手术组,还是植入组织补片组,各组间P0.05,均无统计学差异,所以暂不认为腮腺摘除部位及大小对腮腺术后出现Frey综合征的概率有明显影响。经过问卷调查统计结果显示,常规手术组有4(4.60%)例患者术后出现手术区域局部瘙瘁及全身疼痛等不良反应,植入组织补片组有53例(71.62%)出现上述不良反应,行卡方检验,P0.05,具有统计学意义。所有病例在术后均未出现严重过敏等其他不良反应。结论：异种脱细胞真皮基质在腮腺切除术后3年以上出现Frey综合征预防中起到一定程度作用,是一种有效的预防方法,但是也会导致局部瘙痒及疼痛等术后并发症。
[Abstract]:Objective: to evaluate the clinical efficacy of acellular allogenic dermal matrix (ADM) in preventing Frey syndrome after parotid gland operation. Methods: from 2005 to 2010 161 patients with parotid benign tumor were treated in oral and maxillofacial surgery of Shandong Provincial Hospital. The 161 patients were assigned to a retrospective study, the routine operation group (nnm87): the superficial parotid lobe, parotid part or whole parotid lobe were surgically dissected without any filling material, and the tissue patch group (nnm74): the superficial parotid lobe was performed. After parotid partial or total parotid lobectomy, ADM. was implanted between the remaining parotid tissue and the parotid masseter fasciocutaneous flap according to the size of the defect. The occurrence of Frey syndrome was evaluated by questionnaire and 40 patients were randomly selected from each group for objective evaluation by Minor iodide starch test. The differences between the two groups of experimental data were checked by chi-square with SPSS19.0 software. Results: according to the results of questionnaire, 36 (41.38%) of 87 patients in routine operation group had subjective symptoms of Frey syndrome, and 15 (20.27%) of 74 patients in implanted tissue patch group had subjective symptoms of Frey syndrome. Chi-square test showed that there was statistical significance in 蠂 ~ 2 ~ 2 ~ (8.23) P _ (0.05). According to the results of Minor iodine-starch test, 21 (52.5%) of 40 patients in the routine operation group had the objective symptoms of Frey syndrome, and the tissue patch group was implanted into the tissue patch group. Objective symptoms of Frey syndrome were found in 10 patients (25.0%). Chi-square test was performed. At the same time, we studied the effect of parotid gland excision site and size on Frey syndrome after parotid surgery. There was no significant difference between the two groups in both conventional operation group and implanted tissue patch group (P0.05). Therefore, it is not considered that the location and size of parotid gland extirpation has a significant effect on the probability of Frey syndrome after parotid surgery. The results of questionnaire survey showed that 4 (4.60%) patients in the routine operation group had local pain in the operation area and 53 (71.62%) patients in the implanted tissue patch group. Chi square test, P0.05, has statistical significance. No other adverse reactions such as severe allergies were found in all patients after operation. Conclusion: xenogeneic acellular dermal matrix plays a role in the prevention of Frey syndrome more than 3 years after parotidectomy. It is an effective method to prevent Frey syndrome, but it can also lead to postoperative complications such as local pruritus and pain.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.7

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