面神经解剖在80例腮腺手术患者中的应用

目的将面神经解剖技术应用于腮腺手术治疗中，并观察其临床应用效果。方法对比分析法是对应用顺行法与逆行法在实施腮腺手术的患者临床资料进行分析的一种方法，本文采用这种方法对我院自2011年3月至2013年3月收治的80例病患资料进行临床分析，按照随即抽取法将其分为A组与B组，其中A组患者应用顺行法（即通过找出面神经总干再分离各分支的方法）进行治疗，B组患者应用逆行法（即通过找出下颌缘支再经由其他分支找到主干的方法）进行治疗，每组患者各40例。结果A组与B组两种面神经解剖方法在腮腺手术中均取得了良好的临床解剖效果，对面部神经起到了很好的保护作用，其中A组神经功能损伤发生率为7．5％，B组神经功能损伤发生率为5％，两组术式治疗数据不存在明显差异，无具有统计学意义（P〉0．05）。除了切断恶性肿瘤侵犯面神经以外，没有一例病患出现面神经离断而导致的永久性面神经损伤，出现轻度的下领缘支受损的症状的患者有3例，出现颧支及颞支受损的症状的患者各有l例，随访3～6个月后，患者病症基本恢复。结论采用两种方法进行面神经解剖，具有良好的临床治疗效果，但是A组手术恢复时长明显短于B组，如果将两种方法相结合，则会起到保护面神经的作用，从而降低面神经的损伤率。

Applied Anatomy of the Facial Nerve in 80 Patients with Parotid Gland Operation

Objective The facial nerve dissection techniques used in the surgical treatment of parotid and observe its clinical application. Methods A comparative analysis is on the application of anterograde and retrograde approach in the implementation of Law parotid surgery clinical data analysis method, we use this method in our hospital from March 2011 - March 2013 were treated 80 cases clinical analysis of patient data, in accordance with the law will be randomly selected and divided into group A, group B, group A patients antegrade approach （ie, by identifying and then separating the facial nerve branches total dry method） for treatment, B group patients with retrograde method （ie by finding the marginal mandibular branch to find the trunk and then through the other methods） for treatment, 40 patients in each group of patients. Results A group and B group two kinds of facial nerve in parotid gland surgery methods have achieved good results in clinical anatomy of the facial nerve has played a very good protection, where A group of neurological injury rate 7.5%, B group neurological injury rate of 5%, two surgical treatment of the data is not significantly different, no statistically significant（P〉0.05）. Apart from cutting malignant tumors invading the facial nerve, which no one cases of patients present with facial nerve transection caused permanent facial nerve injury, a mild damage to the marginal mandibular branch of the patients had symptoms of three cases, there zygomatic and temporal branch damage symptoms have one case, follow-up 3-6 months later, the patient illness recovered. Conclusion The use of two methods for facial nerve, has a good clinical effect, but the A group, the length of recovery operation was shorter in group B, if the combination of the two methods, will play the role of protecting the facial nerve, thereby reducing the facial nerve damage rates.