应用阿托品及加压包扎对预防腮腺切除术后涎瘘的疗效观察

Efficacy of Atropine and Pressure Dressing on Preventing Salivary Fistula after Parotid Benign Tumor Resection

目的 观察口服阿托品及腮腺区加压包扎时间的长短对预防腮腺切除术后涎瘘发生的疗效.方法 将108例行腮腺切除的病例依据术后处理方法的不同分为4组,每组27例.A组,B组患者术后三餐前半小时均口服阿托品,但A组腮腺区术后加压包扎3d,B组腮腺加压包扎10d.C组,D组患者均未口服阿托品,C组腮腺区加压包扎3d,D组加压包扎10d.术后随访1个月,观察术区是否有涎瘘发生.结果 4组涎瘘发生率分别为7.41﹪,3.70﹪,3.70﹪,3.70﹪;B组,C组,D组之间差异无显著性,A组和其他3组之间差异亦无统计学意义（P〉0.05）.结论 腮腺切除术后,在相同加压包扎时间内,是否口服阿托品对预防涎瘘的发生没有显著影响;而给予患者相同的药物处理方法后,加压包扎的时间在3d时已经明显地减少涎瘘的发生率,过长的加压包扎无显著临床意义.

Objective To ovserve the effect of atropine and pressure dressing on preventing salivary fistula＇s occurrence ＇after parotid benign tumor resection. Methods One hundred and eight patients underwent surgery in parotid were enrolled in this study. According to the different treatment methods after the surgery,they were divided into four groups with 27 people in each group. Patients of group A and B two took atropine orally half an hour befol~ meals,and were given compression bandage for 3 days and 10 days respectively. Patients of Gl^mp C and D didnt take atropine,and they were just given compression bandage,3 days for group C and 10 days for group D. They were followed up fur a month. Results The salivary fistula rate of the four groups was 7.41% ,3.70 % ,3.70 % ,3.70 % respectively,and there was no significant difference between groupA and C,as well as between group B and D,group A and B,group C and D（P 〉 0.05）. Conclusion After parotid benign tumor resection whether to take atropine or not had no obvious effect on preventing salivary fistula with the same bandage time. On the other hand,3 clays＇bandage time played an apparent action on preventing salivary fistula,while 10 days＇bandage made no sense as long as the same dose of atropine was taken.