【摘要】：目的：涎瘺為腮腺病變術(shù)后常見(jiàn)的并發(fā)癥,術(shù)后放置負(fù)壓引流結(jié)合繃帶加壓包扎1周時(shí)間,已經(jīng)成為腮腺術(shù)后預(yù)防涎瘺的常規(guī)方法。本研究著重于評(píng)價(jià)在腮腺淺葉及部分切除術(shù)中應(yīng)用單純負(fù)壓引流預(yù)防涎瘺的臨床價(jià)值,并根據(jù)術(shù)后引流量、引流天數(shù)與涎瘺的關(guān)系,尋找最佳的拔管時(shí)機(jī)。 方法：不保留腮腺導(dǎo)管的腮腺淺葉切除的腮腺疾病病人194例,分為傳統(tǒng)加壓組(82例)和單純負(fù)壓組(112例)：腮腺部分切除術(shù)病人103例,傳統(tǒng)加壓組(50例)和單純負(fù)壓組(53例)。傳統(tǒng)加壓組病人拔除引流管后繼續(xù)加壓包扎,單純加壓組病人拔管后不再加壓包扎；記錄術(shù)后涎瘺情況,分別對(duì)比兩種術(shù)式中兩組涎瘺率的差異,同時(shí)分析單純負(fù)壓組引流量、引流天數(shù)與術(shù)后涎瘺的關(guān)系。 結(jié)果：兩種術(shù)式中,傳統(tǒng)加壓組涎瘺率與單純負(fù)壓組涎瘺率對(duì)比均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)；兩種術(shù)式的單純負(fù)壓組,引流天數(shù)與涎瘺率對(duì)比均無(wú)明顯相關(guān)(P0.05)；對(duì)于腮腺淺葉切除術(shù)引流量少于20m1與(20-30)ml對(duì)比術(shù)后涎瘺率差異顯著,而腮腺部分切除術(shù)中引流量在(0-10)m1與(20～30)ml對(duì)比中,差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論：?jiǎn)渭冐?fù)壓引流能代替?zhèn)鹘y(tǒng)拔管后繼續(xù)加壓包扎預(yù)防涎瘺,從而避免了因繃帶加壓包扎引起的諸多并發(fā)癥：另外,在評(píng)估拔管時(shí)機(jī)時(shí),引流量比引流時(shí)間更重要,在腮腺淺葉切除術(shù)后,引流量小于20ml可作為最佳的拔管時(shí)機(jī)；而在腮腺部分切除術(shù),要求引流量小于10ml。預(yù)防涎瘺不采用加壓包扎,治療涎瘺采用加壓包扎可作為一項(xiàng)共識(shí)進(jìn)行推廣。
[Abstract]:Objective: salivary fistula is a common complication after parotid gland disease. It has become a routine method to prevent salivary fistula after parotid gland operation by placing negative pressure drainage and bandage and bandaging for one week. The purpose of this study was to evaluate the clinical value of simple negative pressure drainage in the prevention of salivary fistula in parotid superficial lobectomy and partial resection, and to find the best extubation time according to the relationship between drainage time and salivary fistula. Methods: 194 patients with parotid gland disease were divided into traditional compression group (82 cases) and simple negative pressure group (112 cases): partial parotidectomy group (103 cases), traditional pressure group (50 cases) and simple negative pressure group (53 cases). The patients in the traditional pressure group continued to apply pressure bandage after the drainage tube was removed, and the patients in the simple pressure group did not apply the pressure bandage after the extubation, recorded the situation of postoperative salivary fistula, compared the differences of the two groups in the two kinds of operation methods, and analyzed the drainage rate of the simple negative pressure group. The relationship between drainage days and postoperative salivary fistula. Results: there was no significant difference in the rate of salivary fistula between the traditional pressure group and the simple negative pressure group (P0.05), but there was no significant correlation between the days of drainage and the rate of salivary fistula in the simple negative pressure group (P0.05). For superficial parotid lobectomy, the drainage volume was less than that of 20m1 and (20-30) ml, but the difference was statistically significant between (0-10) M1 and (20 ~ 30) ml in partial parotid resection. Conclusion: the simple negative pressure drainage can replace the traditional pressure bandaging after extubation to prevent the salivary fistula, thus avoiding many complications caused by bandage pressure bandage. In addition, in evaluating the extubation time, the drainage flow is more important than the drainage time. After superficial parotid lobectomy, drainage less than 20ml is the best time for extubation, while for partial parotid resection, drainage is required to be less than 10ml. Prevention of salivary fistula without pressure bandaging, the treatment of salivary fistula with pressure bandaging can be used as a consensus to promote.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R782.7

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