四种颈淋巴清扫术切口在口腔外科中的比较

Comparative study of different incision for neck dissection

目的 :对四种颈淋巴清扫术常用切口 :改良T形 ,类矩形 ,平行切口以及围裙式切口术中手术野的暴露难易 ,术后伤口的愈合 ,术后的外观进行了比较。方法 :选用本院口腔外科 1987年 6月至 1999年 6月的临床资料 ,统计采用各种术式伤口愈合不良 ,伤口局部坏死 ,伤口裂开的发生情况 ,并主观评价术后的外观。结果 :改良T形有 11/ 6 3伤口愈合不良 ,其中2例伤口裂开 ,3例皮瓣局部坏死 ,类矩形切口伤口愈合不良的发生率为 8/ 5 4,1/ 5 4发生伤口裂开 ,1/ 5 4发生局部坏死。围裙式和平行切口未出现并发症。结论 :四种切口各有优缺点 ,对于术前接受放疗的病人 。

Objective:To Compare four commonly used incisions for neck dissection, modified Crile ,Yoels incision,MacFee and apron incision with respect of their postoperative wound complications. Methods:Retrospective review of 137 neck dissections using above four incisions in department of Oral & Maxillofacial Surgery,Chongqing Medical University Affiliated No.1 Hospital, and compare incidence of undesirable healing, wound dehiscence,partial flap necrosis and postoperative cosmetic result. Results:There were 2/63 wound dehiscence (one of them healed after using saveboat flap) and 3/63 partial marginal flap necrosis in modified Crile group.In Yoel group,there were 1/54 wound dehiscence,1/54 partial flap necrosis. There were no wound complication in apron and MacFee group. Conclusion:Every incision has advantage and disadvantage in radiated neck, but we believe using MacFee and apron would decrease the incidence of flap complication and get good cosmetic result.