不同术式对腮腺混合瘤手术效果的比较

目的：探讨腮腺多行性腺瘤保留功能性的切除在腮腺浅叶中的应用。方法：选择位于腮腺浅叶的多行性腺瘤20例,另选30例作为对照组。在多行性腺溜瘤体包膜外0.5-1.0 cm正常腮腺组织内,切除瘤体及腺体。比较术后并发症、复发率、面部畸形及残留腺体的功能。结果：观察组较对照组并发症少,术后畸形小,残留腺体有功能,随访1-5 a无复发。结论：腮腺浅叶多行性腺瘤功能性切除较经典手术更有优越性。     

腮腺多形性腺瘤手术后复发相关因素分析

目的本丈通过对594例患者进行回顾，分析腮腺多形性腺瘤术后复发的相关因素。方法对594例多形性腺瘤进行回顾及随访调查，结合患者发病年龄，肿瘤部位、大小，组织学形态及手术方式，统计描述术后复发的原因。结果594例患者中，术后复发36例，复发率为6．1％，肿瘤包膜完整的术后复发率为1．5％，包膜不完整的复发率为35％，统计学有显著差异（P〈0．01）。深叶肿瘤的术后复发率较浅叶肿瘤的复发率高，分别为22％及4％，肿瘤加腮腺浅叶切除术后的复发率低于肿瘤加腮腺全切除术后的复发率。结论影响腮腺多形性腺瘤术后复发的相关因素有：肿瘤的组织病理学特征、肿瘤的发生部位及手术方式，强调严格遵守无瘤的操作原则，首次手术彻底切除至关重要。     

保留腮腺主导管的腮腺肿瘤浅叶部分切除术的疗效观察

目的探讨保留腮腺主导管的腮腺肿瘤浅叶部分切除术临床效果及安全性。方法腮腺肿瘤患者74例，采用随机数字表法分为对照组（B组）和浅叶部分切除组（A组），每组各37例，分别采用传统浅叶全切术和保留腮腺主导管浅叶部分切除术治疗。比较两组患者手术切口长度、Ⅰ期愈合率，术后复发率及术后并发症发生情况等。结果 A组患者手术切口长度及Ⅰ期愈合率均明显优于B组，组间比较差异有统计学意义（P〈0.05）。两组患者术后复发率均为5.4%；两组患者术后复发率组间比较无显著差异（P〈0.05）。A组患者术后唾液积留、涎瘘、面部畸形、面瘫及Frey综合征等并发症发生率均明显优于B组，组间比较差异有统计学意义（P〈0.05）。结论相比较传统浅叶全切术，保留腮腺主导管的腮腺肿瘤浅叶部分切除术能够有效减少手术创伤，减少复发率，降低术后并发症出现风险，临床效果确切。     

腮腺多形性腺瘤73例手术治疗效果分析

目的 :探讨腮腺多形性腺瘤的手术方式。方法 :回顾性分析 73例腮腺多形性腺瘤的临床资料 ,手术方式与术后并发症的关系。结果 :73例腮腺多形性腺瘤术后 5例复发。 4例发生味觉性出汗综合征 ,2例形成涎瘘。结论 :腮腺多形性腺瘤的手术方式有多种 ,但以保留面神经的肿瘤及腮腺部分切除术为比较理想的术式。     

区域性腮腺切除术治疗腮腺浅叶良性肿瘤的疗效观察

目的探讨区域性腮腺切除术治疗腮腺浅叶良性肿瘤的临床疗效。方法对34例腮腺浅叶良性肿瘤患者（肿瘤直径均≤3.0 cm）均采用区域性腮腺切除术治疗。采用类＂N＂形美容切口,在距肿瘤边界1.0 cm处的正常腺体内切除肿瘤。观察34例患者术后有无并发症发生及腮腺浅叶良性肿瘤的复发等情况。结果 34例患者术后切口均一期愈合。3例患者术后出现暂时性面瘫,在2周~3个月内恢复正常;1例患者术后出现味觉出汗综合征。术后无一例出现唾液潴留及涎瘘。34例患者获随访6个月~2年,肿瘤无复发。腮腺乳头丰满,分泌功能良好。结论对于体积较小的腮腺浅叶良性肿瘤采用区域性腮腺切除术治疗,具有手术创伤小、并发症少及肿瘤复发率低等优点,可作为体积较小的腮腺浅叶良性肿瘤治疗的首选术式。     

腮腺浅叶部分切除术对腮腺浅叶良性肿瘤患者腺体功能及复发率的影响

目的研究腮腺浅叶部分切除术(PSP)对腮腺浅叶良性肿瘤患者腺体功能及复发率的影响。方法将60例腮腺浅叶良性肿瘤患者根据随机数表法分为2组:对照组30例采取浅叶切除术(SP)治疗,观察组30例采取PSP治疗。比较2组术后腺体功能保留率、复发率及并发症发生率。结果观察组腺体功能保留率明显高于对照组(96.67%比16.67%,χ~2=39.095、P<0.001),并发症发生率明显低于对照组(6.67%比26.67%,χ~2=4.320、P=0.038);2组术后复发率比较差异无统计学意义(10.00%比3.33%,χ~2=0.268、P>0.05)。结论对腮腺浅叶良性肿瘤患者行PSP治疗,可有效保护其腺体功能,降低并发症发生率,且未增加复发率。     

腮腺部分切除术治疗腮腺多形性腺瘤的临床疗效分析

【目的】探讨保留腮腺主导管的腮腺部分切除术在治疗肿瘤直径小于3．0cm的腮腺多形性腺瘤（PAG）的可行性。[方法]36例PAG随机分为三组,其中16例采用腮腺部分切除术（A组）,12例行腮腺浅叶切除术（B组）,8例行腮腺全切除术（C组）,随访时间3-5年。【结果】A组术后瘢痕和面部凹陷畸形、味觉出汗综合征（Frey综合征）、暂时性面瘫发生及腮腺功能等方面均优于B、C组,肿瘤的复发无明显差异。【结论】腮腺部分切除手术创伤小,并发症少,还可以保存腮腺一定的功能,是PAG临床治疗的理想术式。     

区域性切除术在腮腺浅叶良性肿瘤治疗中的疗效分析

目的:分析区域性切除术在腮腺浅叶良性肿瘤治疗中的疗效。方法:选取2016年6月～2017年9月我院收治的80例腮腺浅叶良性肿瘤患者作为研究对象,采用入院单双数法分为对照组和观察组,每组40例。对照组采用传统切除术,观察组采用区域性切除术,比较两组的临床治疗结果、并发症发生情况和手术情况。结果:观察组患者术中各指标均优于对照组,差异均有统计学意义,P0.05;观察组并发症发生率低于对照组,差异有统计学意义,P0.05;两组复发率相比较,差异无统计学意义,P0.05。结论:采用区域性切除术治疗腮腺浅叶良性肿瘤患者可提升治疗效果,降低术后并发症发生率。     

不同手术方式治疗腮腺浅叶良性肿瘤的效果探讨

目的探讨应用腮腺浅叶腺体部分切除和传统的全切除术两种不同的手术方法治疗腮腺浅叶良性肿瘤的临床效果。方法选择2013年1月至2017年1月某院收治的114例腮腺浅叶肿瘤患者作为研究对象,将给予传统的腮腺浅叶全切除术进行治疗的患者设为对照组(57例),将采用腮腺浅叶腺体部分切除术进行治疗的患者设为实验组(57例)。比较两组患者的术中出血量、手术切口长度;随访1年统计口干、涎瘘、暂时性面瘫、Frey综合征、面部凹陷畸形等并发症发生率以及肿瘤复发情况。结果实验组患者的术中出血量、手术切口长度均低于对照组,差异有统计学意义(P0.05)。实验组口干、涎瘘、暂时性面瘫、Frey综合征、面部凹陷畸形等各项并发症发生率均低于对照组患者,差异有统计学意义(P0.05);两组患者的肿瘤复发率比较差异无统计学意义(P0.05)。结论相比传统全切除术而言,应用腮腺浅叶腺体部分切除术治疗腮腺浅叶良性肿瘤,手术创伤小,并发症少,临床效果更好。     

腮腺浅叶良性肿瘤切除32例分析

目的探讨保留腮腺功能的浅叶部分切除术治疗腮腺浅叶良性肿瘤的可靠性。方法对采取该术式治疗的32例病例进行回顾分析。术后6个月-2 a,观察有无复发、并发症和腮腺功能等情况。结果均无永久性面瘫,未出现味觉出汗综合征,无术后复发。其中23例术后患者面部基本对称,2例出现暂时性面瘫,1例出现腮腺瘘（2周后愈合）。结论保留腮腺功能的浅叶部分切除术术式是可靠的,有一定优越性。     

The importance of postoperative radiotherapy against polymorphous low-grade adenocarcinoma of the parotid gland: case report and review of the literature

Polymorphous low-grade adenocarcinoma (PLGA) of the salivary gland is a disease entity that is a recently described form of adenocarcinoma. PLGA most commonly arises in the minor salivary glands. We report two cases of PLGA of the parotid gland. Case 1: A 52-year-old female visited the University of Tsukuba Hospital with a painless mass in the left parotid region. A superficial parotidectomy and postoperative radiotherapy were performed. The patient has been free from disease for 50 months. Case 2: A 55-year-old female initially noticed a painless slowly growing mass in the left parotid region. The tumor was removed with a superficial parotidectomy. The local recurrence was found 6 years after the initial surgery. The recurrent tumor was removed, and radiotherapy was administered thereafter. The patient has been free from the disease for 33 months since the last treatment. The treatment for the primary lesion is crucial for the prognosis since metastasis to the regional lymph node or to distant region is unusual in PLGA. Although surgical extirpation is the recommended modality for treatment of PLGA, wide resection with a safety margin is often difficult in the parotid gland because of the presence of the facial nerve. Our two cases were successfully treated with surgery and postoperative radiotherapy. Although our literature search revealed 32 previously reported cases of PLGA of the parotid gland, only five of the 32 cases were treated postoperative radiotherapy. We highlight the importance of postoperative radiotherapy for PLGA of the parotid gland.     

胸锁乳突肌肌瓣修复腮腺肿瘤切除术后组织缺损

目的探讨腮腺肿瘤手术中即刻修复面部凹陷畸形,以降低术后味觉出汗综合征（Frey’s综合征）的一种手术术式。方法选择2006年1月至2009年1月我院腮腺肿瘤住院手术患者68例,随机分为实验组48例,对照组20例．实验组病人按常规“S”切口施行腮腺肿瘤加腮腺浅叶或全叶切除术,同期行胸锁乳突肌肌瓣转移修复术;对照组则不行同期肌瓣修复,经随访对比观察6个月～3年。结果对照组局部凹陷畸形发生率为90％（18／20）,Frey综合征发生率为55％（11／20）;实验组局部凹陷畸形发生率为16．67％（8／48）,Frey’s综合征发生率为8．33％（4／48）,经统计学处理差异有统计学意义（P〈0．01）。结论胸锁乳突肌肌瓣转移修复术是一种即刻修复腮腺肿瘤术后面部凹陷畸形和降低Frey综合征的较好术式。     

Pattern of facial nerve palsy during parotidectomy: a single-center experience

ObjectiveThis study was performed to report and analyze the prevalence of permanent facial nerve paralysis following parotidectomy for various benign and malignant lesions in a single center.MethodsThis single-center retrospective study included all patients who underwent parotidectomy (total and superficial) for benign and malignant tumors and chronic inflammatory diseases during a 6-year period. Patients who had previously undergone an operation of the parotid gland and those with preoperative facial weakness were excluded.ResultsThe study included 127 patients ranging in age from 14 to 83 years (median, 45.89 years). Most patients were female (n = 83, 65.4%). The most prevalent procedure was superficial parotidectomy (n = 117, 92.1%), followed by total parotidectomy (n = 6, 4.7%). The average operative duration was 138 minutes (range, 80–400 minutes). Histopathology revealed that 109 (85.8%) patients had benign tumors, 14 (11.0%) had malignant tumors, and 4 (3.1%) had chronic sialadenitis. Only two patients sustained an injury to the cervical branch of the facial nerve.ConclusionIn this single-center experience of parotid surgery, the rates of transient and permanent facial paralysis were acceptably low at 9.0% and 1.6%, respectively, for all pathologies.     

Sonohistology for the computerized differentiation of parotid gland tumors

A system for the computerized differentiation of parotid gland tumors is proposed. The parotid gland is the largest of the salivary glands. It is found in the subcutaneous tissue of the face, overlying the mandibular ramus and anterior and inferior to the external ear. The classification system is based on a multifeature tissue characterization approach, using fuzzy inference systems as higher-order classifiers. Baseband ultrasonic echo data were acquired during conventional ultrasound imaging examinations using standard ultrasound equipment. Several tissue-describing parameters were calculated within numerous small regions of interest to evaluate spectral and textural tissue properties. The parameters were processed by an adaptive network-based fuzzy inference system, using the results of conventional histology after parotidectomy as the "gold standard." The results of the classification are presented as a numerical score indicating the probability of a certain tumor or alteration for each parotid gland. The score can be presented to the physician during examination of the patient to improve the differentiation between various types of parotid gland tumors. The system was evaluated on n = 23 cases of patients undergoing radical parotidectomy. The receiver operating characteristic curve area is A(ROC) = 0.95 +/- 0.07 when using fourfold cross-validation over cases and differentiating between various benign parotid gland tumors and monomorphic adenoma.     

腮腺良性肿瘤超声造影定性诊断及术式改良的研究进展

腮腺良性肿瘤的治疗以手术为主，传统术式常出现不同的术后并发症，近年来关于腮腺部分切除、功能性手术的报道众多。施行腮腺部分切除术，术前定性诊断十分重要。腮腺肿瘤的术前辅助诊断手段较多，但无创且准确的诊断是医患双方力求达到的目标，目前彩色多普勒超声造影已广泛应用在腮腺肿瘤的术前诊断中。本文将对腮腺良性肿瘤术式改良方面以及超声造影对腮腺肿瘤术前定性诊断的研究进展进行综述。     

28例婴幼儿腮腺血管瘤手术治疗

目的探讨婴幼儿腮腺血管瘤的手术治疗要点和手术治疗效果。方法28例婴幼儿腮腺血管瘤,年龄2个月～1岁,均施行保留面神经的全腮腺或血管瘤切除术,随访1～5年,检查患者有无永久性面瘫等并发症。结果创口全部I期愈合,无感染、无永久性面瘫等并发症。结论婴幼儿腮腺血管瘤手术治疗可获得满意治疗效果,保护面神经及控制出血是手术成功的关键。     

半夏泻心汤配合中药足浴治疗慢性浅表性胃炎的疗效观察

[目的]观察半夏泻心汤加减配合中药足浴治疗慢性浅表性胃炎的临床疗效。[方法]将68例慢性浅表性胃炎病人随机分为两组,治疗组予半夏泻心汤加减配合中药足浴治疗,对照组予单纯半夏泻心汤加减治疗,两组疗程均为15d,疗程结束后观察两组病人的临床疗效及不良反应。[结果]治疗组总有效率95.0%,对照组总有效率83.3%,两组总有效率比较差异有统计学意义(P0.05)。[结论]半夏泻心汤配合中药足浴治疗慢性浅表性胃炎疗效优于对照组,且安全性好。