颈淋巴结清扫术不同解剖入路发生乳糜瘘或副神经损伤的经验探讨

发布时间：2018-06-15 08:07

  本文选题：颈淋巴结清扫术 + 解剖入路　； 参考：《中国现代医学杂志》2017年02期

【摘要】：目的探讨颈淋巴结清扫术不同解剖入路致乳糜瘘或副神经损伤的比较。方法选择中南大学湘雅医院2013年1月-2014年1月行根治性和功能性颈淋巴结清扫术的下咽癌80例,采用数字表随机法分为4组,每组20例,分别采用4种不同的手术入路进行颈淋巴结清扫术暴露颈鞘,观察患者颈淋巴结清扫术中乳糜瘘和副神经损伤情况,暴露度及手术时间。结果 A组并发症发生率为15%;B组为5%;C组为10%;D组为5%;D组在清扫Ⅴ区时发生2例副神经切断;A组并发症发生率高于B组、D组(P0.05)。4组术野暴露评分由高到低依次是D组、C组、A组和B组。D组、C组Ⅱ、Ⅲ、Ⅳ区术野暴露评分高于A组、B组,D组、C组与A组、B组比较差异具有统计学意义(P0.05)。结论根据病情选择颈淋巴结清扫的手术入路,熟悉颈部解剖层次,是减少颈淋巴结清扫术并发症发生的关键。
[Abstract]:Objective to investigate the comparison of chylous fistula and accessory nerve injury caused by different anatomical approaches of neck lymph node dissection. Methods 80 patients with hypopharyngeal carcinoma who underwent radical and functional neck lymph node dissection in Xiangya Hospital of Central South University from January 2013 to January 2014 were randomly divided into 4 groups with 20 cases in each group. The cervical sheath was exposed by four different surgical approaches. The conditions of chylous fistula and accessory nerve injury, the exposure degree and the operation time during neck lymph node dissection were observed. Results the incidence of complications in group A was 15: 5 in group B, 5 in group C, 10 in group D and 5 in group D during dissection of area 鈪，

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