游离保留SMAS术与非游离保留SMAS术对腮腺肿瘤患者术后Frey综合征及术后复发的影响

目的对比游离保留表浅肌肉健膜系统(SMAS)术与非游离保留SMAS术对腮腺肿瘤患者术后Frey综合征及术后复发的影响。方法选择腮腺肿瘤患者99例,根据随机数字表法分为研究组50例与对照组49例,对照组给予非游离保留SMAS术,研究组给予游离保留SMAS术,记录与随访术后Frey综合征及术后复发情况。结果两组的切口长度、手术时间对比差异无统计学意义(P>0.05),研究组的术中出血量与术后住院时间显著少于(短于)对照组(P<0.05)。术后7 d研究组的面神经分级显著好于对照组(P<0.05)。研究组术后6个月的主观与客观判定Frey综合征的比例为2.0%和6.0%,显著低于对照组的14.3%和22.4%(P<0.05)。研究组术后1年的复发率为2.0%,显著低于对照组的12.2%(P<0.05)。结论相对于非游离保留SMAS术,游离保留SMAS术在腮腺肿瘤患者中的应用能减少创伤,改善面神经功能,减少术后Frey综合征及术后复发的发生。

Effects of Free Retention of SMAS and Non-free Retention of SMAS on Postoperative Frey Syndrome and Postoperative Recurrence in Patients with Parotid Gland Tumors

Objective To compare the effects of free retention superficial muscle membrane system(SMAS)and non-free retention of SMAS for postoperative Frey syndrome and postoperative recurrence in patients with parotid gland tumors.Methods 99 patients with parotid gland tumors were enrolled and divided into 50 patients in the study group and 49 patients in the control group according to the random number table method.The control group were given non-free retention of SMAS,and the study group were given free retention of SMAS.The Frey syndrome and postoperative recurrence were recorded and followed up.Results There were no significant difference in the length of incision and operation time between the 2 groups(P>0.05).The intraoperative blood loss and postoperative hospital stay were significantly less(shorter)in the study group than that of the control group(P<0.05).The facial nerve grading of the study group were significantly better than that of the control group at 7 days after surgery(P<0.05).The subjective and objective judgment of Frey syndrome in the study group at 6 months after surgery were 2.0%and 6.0%,which were significantly lower than 14.3%and 22.4%of the control group(P<0.05).The 1-year recurrence rates were 2.0%in the study group,which were significantly lower than the 12.2%in the control group(P<0.05).Conclusion Compared with non-free retention of SMAS,the use of free-preserved SMAS in patients with parotid tumors can reduce trauma,improve facial nerve function,and reduce postoperative Frey syndrome and postoperative recurrence.