【摘要】：目的：評估脫細(xì)胞異體真皮基質(zhì)(ADM)對預(yù)防腮腺術(shù)后出現(xiàn)Frey綜合征的臨床療效。 方法：2005～2010年于山東省立醫(yī)院口腔頜面外科行腮腺良性腫瘤摘除術(shù)且擁有完整回訪資料的患者共161例。將這161名患者設(shè)為回顧性研究對象,常規(guī)手術(shù)組(n=87)：按常規(guī)行腮腺淺葉、腮腺部分或腮腺全葉摘除術(shù),不植入任何填充材料；植入組織補(bǔ)片組(n=74)：在行腮腺淺葉、腮腺部分或腮腺全葉摘除術(shù)后,根據(jù)缺損面積大小在剩余腮腺組織及腮腺咬肌筋膜皮瓣之間植入ADM。所有患者均通過問卷調(diào)查的方式對Frey綜合征發(fā)生情況進(jìn)行主觀評估；同時于每組中各隨機(jī)抽取40名患者行Minor碘-淀粉實(shí)驗(yàn)進(jìn)行客觀評估。應(yīng)用SPSS19.0軟件對兩組實(shí)驗(yàn)數(shù)據(jù)差異性行卡方檢驗(yàn)。 結(jié)果：根據(jù)問卷調(diào)查結(jié)果顯示,常規(guī)手術(shù)組87名患者中,有36名患者(41.38%)出現(xiàn)Frey綜合征的主觀癥狀,植入組織補(bǔ)片組74名患者中,有15名患者(20.27%)出現(xiàn)Frey綜合征的主觀癥狀,行卡方檢驗(yàn),χ2=8.23,P0.05,具有統(tǒng)計學(xué)意義；根據(jù)Minor碘-淀粉實(shí)驗(yàn)結(jié)果顯示：常規(guī)手術(shù)組40名患者中,有21名患者(52.5%)出現(xiàn)Frey綜合征的客觀癥狀,植入組織補(bǔ)片組,有10名患者(25.0%)出現(xiàn)Frey綜合征的客觀癥狀,行卡方檢驗(yàn),χ2=6.36,P0.05,具有統(tǒng)計學(xué)意義。同時我們將腮腺摘除部位及大小對腮腺術(shù)后出現(xiàn)Frey綜合征的影響進(jìn)行了統(tǒng)計學(xué)研究,無論是常規(guī)手術(shù)組,還是植入組織補(bǔ)片組,各組間P0.05,均無統(tǒng)計學(xué)差異,所以暫不認(rèn)為腮腺摘除部位及大小對腮腺術(shù)后出現(xiàn)Frey綜合征的概率有明顯影響。經(jīng)過問卷調(diào)查統(tǒng)計結(jié)果顯示,常規(guī)手術(shù)組有4(4.60%)例患者術(shù)后出現(xiàn)手術(shù)區(qū)域局部瘙瘁及全身疼痛等不良反應(yīng),植入組織補(bǔ)片組有53例(71.62%)出現(xiàn)上述不良反應(yīng),行卡方檢驗(yàn),P0.05,具有統(tǒng)計學(xué)意義。所有病例在術(shù)后均未出現(xiàn)嚴(yán)重過敏等其他不良反應(yīng)。 結(jié)論：異種脫細(xì)胞真皮基質(zhì)在腮腺切除術(shù)后3年以上出現(xiàn)Frey綜合征預(yù)防中起到一定程度作用,是一種有效的預(yù)防方法,但是也會導(dǎo)致局部瘙癢及疼痛等術(shù)后并發(fā)癥。
[Abstract]:Objective: to evaluate the clinical efficacy of acellular allogenic dermal matrix (ADM) in preventing Frey syndrome after parotid gland operation. Methods: from 2005 to 2010 161 patients with parotid benign tumor were treated in oral and maxillofacial surgery of Shandong Provincial Hospital. The 161 patients were assigned to a retrospective study, the routine operation group (nnm87): the superficial parotid lobe, parotid part or whole parotid lobe were surgically dissected without any filling material, and the tissue patch group (nnm74): the superficial parotid lobe was performed. After parotid partial or total parotid lobectomy, ADM. was implanted between the remaining parotid tissue and the parotid masseter fasciocutaneous flap according to the size of the defect. The occurrence of Frey syndrome was evaluated by questionnaire and 40 patients were randomly selected from each group for objective evaluation by Minor iodide starch test. The differences between the two groups of experimental data were checked by chi-square with SPSS19.0 software. Results: according to the results of questionnaire, 36 (41.38%) of 87 patients in routine operation group had subjective symptoms of Frey syndrome, and 15 (20.27%) of 74 patients in implanted tissue patch group had subjective symptoms of Frey syndrome. Chi-square test showed that there was statistical significance in 蠂 ~ 2 ~ 2 ~ (8.23) P _ (0.05). According to the results of Minor iodine-starch test, 21 (52.5%) of 40 patients in the routine operation group had the objective symptoms of Frey syndrome, and the tissue patch group was implanted into the tissue patch group. Objective symptoms of Frey syndrome were found in 10 patients (25.0%). Chi-square test was performed. At the same time, we studied the effect of parotid gland excision site and size on Frey syndrome after parotid surgery. There was no significant difference between the two groups in both conventional operation group and implanted tissue patch group (P0.05). Therefore, it is not considered that the location and size of parotid gland extirpation has a significant effect on the probability of Frey syndrome after parotid surgery. The results of questionnaire survey showed that 4 (4.60%) patients in the routine operation group had local pain in the operation area and 53 (71.62%) patients in the implanted tissue patch group. Chi square test, P0.05, has statistical significance. No other adverse reactions such as severe allergies were found in all patients after operation. Conclusion: xenogeneic acellular dermal matrix plays a role in the prevention of Frey syndrome more than 3 years after parotidectomy. It is an effective method to prevent Frey syndrome, but it can also lead to postoperative complications such as local pruritus and pain.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R782.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 溫玉明,陳潤良,王昌美;腮腺多形性腺瘤腺體切除范圍的病理依據(jù)[J];華西口腔醫(yī)學(xué)雜志;2003年05期

2 徐曉剛,周中華,王悅;插補(bǔ)鄰近組織瓣預(yù)防腮腺切除后味覺出汗綜合征[J];口腔頜面外科雜志;2002年03期

3 周曉萍,張茹慧;味覺出汗綜合征的治療與預(yù)防[J];口腔醫(yī)學(xué);2005年05期

4 羅小波;李慧;潘劍;;腮腺腫瘤術(shù)后味覺出汗綜合征防治的研究進(jìn)展[J];臨床口腔醫(yī)學(xué)雜志;2012年06期

5 郝智;崔建英;;腮腺腫瘤術(shù)后Frey綜合征的發(fā)病機(jī)制和防治措施[J];現(xiàn)代腫瘤醫(yī)學(xué);2008年12期

6 曲延剛,孫樂剛,王玉良,張玉根,李濤,張加林;腮腺手術(shù)置入滌輪薄片預(yù)防Frey綜合征[J];實(shí)用口腔醫(yī)學(xué)雜志;2002年02期

7 柳曉冰,俞光巖;味覺出汗綜合征的臨床分析[J];現(xiàn)代口腔醫(yī)學(xué)雜志;1998年02期

8 李瑞平,吳建新;預(yù)防味覺出汗綜合征的臨床探討[J];現(xiàn)代口腔醫(yī)學(xué)雜志;2002年05期

9 潘斌;;味覺出汗綜合征的防治[J];中國醫(yī)藥導(dǎo)報;2010年09期

10 葉為民;竺涵光;王旭東;鄭家偉;;脫細(xì)胞異體真皮在預(yù)防腮腺手術(shù)后Frey綜合征中的作用[J];中國口腔頜面外科雜志;2006年06期

，

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