功能性颈淋巴清扫术后颈内静脉栓塞的临床研究

Internal Jugular Vein Thrombosis following Functional Neck Dissection

目的：初步了解功能性颈淋巴清扫术后颈内静脉栓塞发病率及其相关因素。方法：2007年1月至2008年12月在我院口腔颌面外科治疗的口腔颌面部癌瘤患者20例,其中男性12例,女性8例,年龄45～70岁,平均年龄59岁。患者均接受原发病灶的切除及同侧的功能性颈清术,病人术后3月复诊,同时行多普勒超声检查颈清术后的颈内静脉通畅情况。结果：通过多普勒超声检查发现1例功能性颈淋巴清扫术后颈内静脉栓塞,颈内静脉栓塞发生率为5%,该病例术中颈内静脉没有较大分支结扎,术后病理证实无区域淋巴结转移,术创无感染,术后4周始,共接受55Gy放疗。结论：功能性颈淋巴清扫术后颈内静脉栓塞发病率不高,胸大肌皮瓣对颈内静脉的压迫,术后放疗对于血管壁的损伤以及术中电刀的应用可能是造成颈内静脉栓塞原因。

Objective： To determine the incidence of internal jugular vein thrombosis after functional neck dissection. Methods： Twenty preserved internal jugular veins in 20 patients undergoing functional neck dissection were available. Patients underwent doppler ultrasonographic examinations of their internal jugular veins, after functional neck dissection for 3 months. Results： Of the 20 internal jugular veins studied, 1 out of 20 （5%）was found to have evidence of thrombosis 3 months postoperative. Conclusion： Our results indicate that the incidence of internal jugular vein thrombosis is relatively low following functional neck dissection. Radiation therapy and regional myocutaneous flaps may have effects on internal jugular vein thrombosis.