腮腺肿瘤不同切口及路径的手术效果比较

目的比较传统“S”形切口皮瓣转移修复术与改良“S”形切口腮腺筋膜缝合术治疗腮腺肿瘤的临床效果。方法将我科2011年3月—2012年3月期间收治的74例腮腺肿瘤患者按随机数字表法分为观察组42例和对照组32例。对照组患者采用“S”形切口及皮瓣转移修复术，观察组患者采用改良“S”形切口及腮腺筋膜缝合术治疗，术后随访1年，记录并比较两组患者并发症发生率及患者对术后切口外观的满意度情况。结果（1）观察组患者并发症发生率为31．0％，明显低于对照组的56．3％，两组比较差异有统计学意义（P〈0．05）；其中观察组患者的暂时性面瘫、耳颞神经综合征（Frey’s综合征）的发生率显著低于对照组（P〈0．05）。（2）两组患者对手术切口外观的满意度构成比无统计学差异（P〉0．05），但观察组术后整体满意度达到10分的患者比例（38．1％）明显高于对照组（15．6％），差异有统计学意义（P〈0．05）。结论改良“S”形切口及腮腺筋膜缝合术治疗腮腺肿瘤较之“S”形切口皮瓣转移修复术并发症发生率低，患者满意度高。

Comparison of clinical efficacy between two kinds of operative approaches to parotid gland tumor

Objective To compare clinical efficacy between traditional S-shaped incision plus skin flap transfer and modified ＂S＂ incision plus parotid fascia suture in treatment of parotid gland tumor. Methods A total of 74 patients with parotid gland tumor ad- mitted from Mar. 2011 to Mar. 2012 were divided into trial group （n =42） and control group （n = 32） at random via numeral table. The control group was treated with S-shaped incision and skin flap, and the trial group with modified S-shaped incision and pa- rotid fascia suture. They were followed up for one year after operation. Postoperative complication and incision appearance were compared between the two groups. Results （ 1 ） The rate of complication of the trial group （31.0%） was significantly lower than that of the control group （56.3%）, with a statistical difference （P 〈 0.05 ） ; so were the incidences of temporary facial paralysis and Frey＇ s syndrome of the trial group （ P 〈 0.05 ）. （2） There was no significant difference in patients＇ satisfaction to postopera- tive incision appearance between the two groups （ P 〉 0.05 ） , but the proportion of the patients who were very satisfied was significantly higher in the trial group（ 38.1% ）than in the control group（ 15.6% ） ,with a statistical difference （P 〈 0.05 ）. Conclusion Modified S-shaped incision and parotid fascia suture for treatment of parotid tumors does better in lowering complication and heightening patient＇ s satisfaction than traditional S-shaped incision and skin flap transfer.