超声刀在开放腮腺手术中的临床研究

目的　比较超声刀在开放腮腺手术与传统腮腺手术中的优缺点。方法　超声刀行开放腮腺手术为治疗组，同期传统手术为对照组，均由同一组医师施行。分别比 较两组手术时间、术中出血量、术后引流量和术后并发症等指标。结果　两组患者性别（χ 2=1.558，P =0.212）、平均年龄（t =-1.118，P =0.268）、病理类型（χ 2=0.002，P =0.967）及肿瘤大小（t =1.781，P =0.080）的差异均无统计学意义。在相同术式中治疗组的手术时间、术中出血量均小于对照组，差异有统计学意义，两组术后引流量差异无统计学意义。术后治疗组1例暂时性面神经麻痹，对照组1例腮腺涎漏。结论　用超声刀行开放腮腺手术要优于传统方法手术，但不可盲目使用超声刀，应该与丝线结扎等传统手术方法相结合。

Controlled clinical study of harmonic scalpel for open parotid surgery

OBJECTIVE To compare the disadvantages and advantages of open parotid surgery with and without using the harmonic scalpel （HS）. METHODS Thirty two patients and 28 patients underwent parotid surgery with HS or without HS （conventional hemostasis group, CH） respectively. The total operative time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared between the two groups. RESULTS The gender composition ratio （Z2=1.558, P=0.212）, average age （t=-1.118, P=0.268）, pathological type （X2=0.002, P=0.967） and tumor size （t=1.781, P=-0.080） of the two groups had no statistical difference. The total operative time, intraoperative bleeding volume in HS group were significantly lower than those of CH group （P〈0.05）. The surgical complications and postoperative drainage volume showed no significant difference between the HS and CH group （P〉0.05）. One case of temporary facial nerve paralysis in HS group and one case ofparotid gland fistula in CH group occurred after operation. CONCLUSION HS provides significant advantages over conventional hemostasis in open parotid surgery. However, it can＇t be used in a blindly exclusive way, but it should be combined with conventional techniques such silk thread ligation.