螺旋水刀在颌下腺手术中的初步应用

Water Jet Dissection in Submandibular Gland Surgery

目的:探讨螺旋水刀在颌下腺手术中的应用价值。方法:随机抽取颌下腺良性肿瘤患者20例,接受颌下腺肿瘤及肿瘤周围部分颌下腺腺体切除术,随机分为实验组和对照组,每组10人,实验组采用螺旋水刀分离颌下腺组织,对照组采用普通口腔颌面外科器械。结果:20例患者颌下腺肿瘤及瘤周部分腺体完整切除,随访均无肿瘤复发;术中测定两组面神经最小刺激电流强度阈值平均0.18mA,与术前的平均0.08mA比较,差异有统计学意义(P<0.05)。术后实验组面神经功能评定,7例为Ⅰ级,2例为Ⅱ级,1例为Ⅲ级;对照组面神经功能评定,8例为Ⅰ级,2例为Ⅱ级。面瘫的发生率差异无统计学意义。术后舌神经功能评定,实验组中8例为Ⅰ级,1例为Ⅱ级,1例为Ⅲ级;对照组中9例为Ⅰ级,1例为Ⅱ级。舌神经损伤的发生率差异无统计学意义。两组均有1例涎瘘发生,发生率差异无统计学意义。结论:利用螺旋水刀可进行精细分离,达到精确地保护血管、神经和管道的目的,具有高度的组织选择性和保护性,安全可靠,是传统颌下腺手术方式的有益补充。

Objective： To study the value of water jet dissection in submandibular gland surgery.Methods： 20 examples were the objects of study,who accepted surgery under the jaw around the gland tumor and the tumor under the partial jaws the auricular gland body excision method.The patients were divided into 2 groups.Result： The gland tumor and the lump week partial glands were excised completely without recrudescence.The smallest stimulation strength of current threshold value was average 0.18mA.The average before was 0.08mA.There had significant difference（P0.05）.After the surgery,the experimental group facial nerve function evaluated： 7 examples were level I,2 examples were level Ⅱ,1 example was level Ⅲ.The control group facial nerve function evaluated： 8 examples were level Ⅰ,2 examples were level Ⅱ.After the surgery,the lingual nerve function evaluation,in the experimental group 8 examples were level Ⅰ,1 example was level Ⅱ,1 example was level Ⅲ.In the control group 9 examples were level I,1 example was level Ⅱ.Conclusion： Spiral water knife does not have any pyrolytic damage,may carry on the fine separation,and protect the blood vessel,the nerve and pipeline＇s goal precisely.