脫細胞真皮基質預防腮腺術后Frey綜合征臨床療效的回顧性研究
發(fā)布時間：2018-10-23 19:35
【摘要】：目的：評估脫細胞異體真皮基質(ADM)對預防腮腺術后出現(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且擁有完整回訪資料的患者共161例。將這161名患者設為回顧性研究對象,常規(guī)手術組(n=87)：按常規(guī)行腮腺淺葉、腮腺部分或腮腺全葉摘除術,不植入任何填充材料；植入組織補片組(n=74)：在行腮腺淺葉、腮腺部分或腮腺全葉摘除術后,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查的方式對Frey綜合征發(fā)生情況進行主觀評估；同時于每組中各隨機抽取40名患者行Minor碘-淀粉實驗進行客觀評估。應用SPSS19.0軟件對兩組實驗數(shù)據(jù)差異性行卡方檢驗。 結果：根據(jù)問卷調查結果顯示,常規(guī)手術組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,χ2=8.23,P0.05,具有統(tǒng)計學意義；根據(jù)Minor碘-淀粉實驗結果顯示：常規(guī)手術組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,χ2=6.36,P0.05,具有統(tǒng)計學意義。同時我們將腮腺摘除部位及大小對腮腺術后出現(xiàn)Frey綜合征的影響進行了統(tǒng)計學研究,無論是常規(guī)手術組,還是植入組織補片組,各組間P0.05,均無統(tǒng)計學差異,所以暫不認為腮腺摘除部位及大小對腮腺術后出現(xiàn)Frey綜合征的概率有明顯影響。經過問卷調查統(tǒng)計結果顯示,常規(guī)手術組有4(4.60%)例患者術后出現(xiàn)手術區(qū)域局部瘙瘁及全身疼痛等不良反應,植入組織補片組有53例(71.62%)出現(xiàn)上述不良反應,行卡方檢驗,P0.05,具有統(tǒng)計學意義。所有病例在術后均未出現(xiàn)嚴重過敏等其他不良反應。 結論：異種脫細胞真皮基質在腮腺切除術后3年以上出現(xiàn)Frey綜合征預防中起到一定程度作用,是一種有效的預防方法,但是也會導致局部瘙癢及疼痛等術后并發(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.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R782.7
本文編號：2290266
[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.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R782.7
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