经侧方颈纹入路行选择性颈淋巴结清扫术的临床初探

doi:10.13591/j.cnki.kqyx.2024.03.003

口腔医学 ›› 2024, Vol. 44 ›› Issue (3): 173-176.doi: 10.13591/j.cnki.kqyx.2024.03.003

经侧方颈纹入路行选择性颈淋巴结清扫术的临床初探

万锦波¹,钱一言²,王羽立¹,肖娜¹,卞一峰¹,杜一飞¹()

1 南京医科大学附属口腔医院口腔颌面外科,江苏南京(210029)
2 南通市通州区人民医院口腔科,江苏南通(226300)

收稿日期:2023-05-29 出版日期:2024-03-28 发布日期:2024-03-20
通讯作者: 杜一飞 E-mail:dyf@njmu.edu.cn
基金资助:
江苏省卫生厅干部保健课题(BJ18035);江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4);江苏省医学创新中心(CXZX202227)

Preliminary study on selective neck dissection via lateral cervical stria approach

WAN Jinbo¹,QIAN Yiyan²,WANG Yuli¹,XIAO Na¹,BIAN Yifeng¹,DU Yifei¹()

Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University, Nanjing 210029, China

Received:2023-05-29 Online:2024-03-28 Published:2024-03-20

摘要/Abstract

摘要：

目的探索侧方颈纹入路在早期口腔恶性肿瘤患者行选择性淋巴结清扫术中的应用。方法选择我院2020年12月至2022年3月收治的22例早期口腔恶性肿瘤患者,原发病灶切除后行选择性颈淋巴结清扫术,分为侧方颈纹入路和常规下颌下入路两组,对手术情况、肩功能及颈部美观评分进行分析。结果两组患者在手术时间、术中出血量、术后引流量、淋巴结数目、淋巴结分期和肩功能评分没有统计学差异;侧方颈纹入路患者术后6个月颈部外观评分高于下颌下入路,差异有统计学差异(P<0.05)。结论经侧方颈纹入路行早期口腔恶性肿瘤患者选择性颈淋巴结清扫术,安全有效,美观评分更高。

关键词: 颈纹, 口腔恶性肿瘤, 选择性颈淋巴结清扫术, 手术入路

Abstract:

Objective To investigate the application of lateral cervical stria approach in selective neck dissection(SND) for patients with early oral malignant tumors.Methods A total of 22 patients underwent SND during December 2020 to March 2022 was retrospectively reviewed and divided into lateral cervical stria and conventional submandibular approach groups. The clinical characteristics, shoulder function and neck aesthetic scoring were compared between two groups. Results There was no statistical difference in operation time, intraoperative bleeding volume, postoperative drainage volume, number and stage of lymph nodes as well as shoulder function scoring between two groups. The appearance score of lateral cervical stria approach was significantly higher than that of patients with submandibular approach 6-month after operation(P<0.05). Conclusion SND via lateral cervical stria approach for patients with early oral malignancies is safe and effective, achieving a better aesthetic outcome.

Key words: cervical stria, oral malignant tumor, selective neck dissection, surgical approach

中图分类号:

R739.8

万锦波, 钱一言, 王羽立, 肖娜, 卞一峰, 杜一飞. 经侧方颈纹入路行选择性颈淋巴结清扫术的临床初探[J]. 口腔医学, 2024, 44(3): 173-176.

WAN Jinbo, QIAN Yiyan, WANG Yuli, XIAO Na, BIAN Yifeng, DU Yifei. Preliminary study on selective neck dissection via lateral cervical stria approach[J]. Stomatology, 2024, 44(3): 173-176.

图/表 4

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临床指标	下颌下入路	侧方颈纹入路	P
病例数/例	12	10
年龄/岁	60.67±11.94	57.80±18.56	0.666
性别(男/女)	6/6	6/4	0.691
病灶分级/例
T1	7	5	>0.999
T2	5	5
清扫范围/例
Ⅰ~Ⅲ区	3	1	0.594
Ⅰ~Ⅴ区	9	9
病理诊断/例
鳞状细胞癌	11	9	>0.999
黏液表皮样癌	1	1
BMI	24.80±4.16	23.63±1.85	0.418
ASA分级(Ⅱ/Ⅲ)	11/1	5/5	0.056

手术情况	下颌下入路	侧方颈纹入路	P
病例数	12	10
手术时间/min	175.33±25.32	197.70±39.63	0.124
出血量/mL	227.50±85.19	165.00±70.91	0.080
负压引流量/mL	358.58±173.79	324.50±96.48	0.587
淋巴结数目	18.08±3.55	17.88±6.45	0.927
淋巴结分期
N₀	11	8	0.571
N₁	1	2
肩功能评估
无障碍	9	9	0.099
轻度	2	0
中度	1	1
颈部外观评分	72.92±4.70	87.50±13.18	0.037

经侧方颈纹入路行选择性颈淋巴结清扫术的临床初探

Preliminary study on selective neck dissection via lateral cervical stria approach

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