腮腺良性肿瘤包膜外切除术的循证医学分析

发布时间：2018-05-02 08:01

本文选题：腮腺肿瘤 + 腮腺包膜外切除术　；参考：《临床耳鼻咽喉头颈外科杂志》2017年11期

【摘要】：目的:比较腮腺包膜外切除术(ECD)和腮腺切叶切除术(SP)术后复发和并发症的发生率,为临床治疗腮腺良性肿瘤选择合适的手术方式提供理论依据。方法:在Pubmed、相关期刊论文(CNKI)和万方数据库检索比较SP和ECD手术方法转归的相关文献,采用RevMan 5.0软件进行Meta分析。结果:获得15篇文献用于Meta分析,共包括2 929例患者,其中1 796例接受ECD,1 133例接受SP。ECD和SP的术后复发率分别为1.29%(23/1 776)和1.48%(16/1 081),差异无统计学意义。ECD与SP术后暂时性面瘫的发生率分别为5.48%(74/1 350)和22.94%(139/606),永久性面瘫的发生率分别为0.66%(8/1 221)和2.71%(15/554),Frey综合征的发生率分别为1.91%(26/1 360)和16.71%(111/664),涎瘘的发生率分别为0.53%(5/946)和2.96%(10/338),与SP相比,ECD术后并发症的发生率明显降低。结论:与SP相比,ECD并发症发生率低,而肿瘤的复发率并没有增高,提示在适应证选择正确的情况下,ECD可以取代SP用于腮腺良性肿瘤的治疗。
[Abstract]:Objective: to compare the incidence of recurrence and complications after excision of parotid gland (ECD) and parotid lobectomy (SPV) so as to provide theoretical basis for clinical treatment of benign parotid tumors. Methods: in Pubmed, CNKI (Chinese Journal Full-text Database) and Wanfang database, we searched and compared the related literatures of SP and ECD surgical methods, and analyzed Meta by RevMan 5.0 software. Results: fifteen articles were obtained for Meta analysis, including 2 929 patients. Among them, 1 796 cases received SP.ECD and 1 133 cases received SP. The postoperative recurrence rates were 1.29 / 1776) and 1.48 / 10 81 respectively. There was no significant difference. The incidence of temporary facial paralysis after ECD and SP was 5.4874 / 1350) and 22.94139P / 606, respectively, and the incidence of permanent facial paralysis was 5.4874 / 1.350) and 22.94139P / 606, respectively. The incidence of Frey's syndrome was 1.91 / 1360 and 16.71 / 1164, respectively. The incidence of salivary fistula was 0.53 / 5 / 946) and 2.96 / 10 / 33 / 38, respectively. Compared with SP, the incidence of postoperative complications of ECD was significantly lower than that of SP. Conclusion: compared with SP, the incidence of complications of ECD is lower, but the recurrence rate of tumor is not increased, which suggests that ECD can replace SP in the treatment of parotid benign tumors.
【作者单位】：河北医科大学第二医院口腔颌面外科;河北医科大学第三医院呼吸睡眠科;
【分类号】：R739.87

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