腮腺肿瘤改良术后TNF-a水平与Frey综合征相关性的研究

Association between TNF-a level and Fyey syndrome after modified operation for parotid gland tumors

目的:探讨腮腺肿瘤改良术后肿瘤坏死因子-a(TNF-a)水平与Frey综合征的相关性。方法:腮腺良性肿瘤85例分为观察组(46例)和对照组(39例),对照组采用常规手术,观察组采用改良术式,术后1、15、30d及2年采用酶联免疫吸附法(ELISA)检测血清中TNF-a水平,术后15、30d及2年所有患者通过调查问卷形式和碘-淀粉试验对Frey综合征分别进行主观评价和客观评价,随访术后2年肿瘤复发情况,并分析TNF-a水平与Frey综合征的相关性。结果:两组15、30d及2年主、客观评价比较,差异均有统计学意义(P均<0.01);观察组3个时间段两两比较,差异均有统计学意义(P均<0.01);对照组3个时间段两两比较,差异均无统计学意义(P均>0.05)。2年后随访,85例患者均未见复发。两组各时间段TNF-a水平差异均有统计学意义(P均<0.01),观察组各时间段两两比较,差异均有统计学意义(P均<0.01),对照组各时间段两两比较,差异均无统计学意义(P均>0.05)。TNF-a水平与Frey综合征有明显相关性(P<0.05)。结论:改良术式能有效防止腮腺术后并发症的发生,TNF-a能作为腮腺术后预防Frey综合征发生的指征之一。

Objective. To investigate association between TNF-a levels and Fyey syndrome after modified operation for parotid gland tumors. Methods： A total of 85 cases with benign parotid gland tumor were randomly divided into observation group （46 cases） and control group （39 cases）. Patients in control group underwent conventional surgery; while patients in the observation group had modified operation. TNF-a level was determined by enzyme-linked immunosorbent assay 1 d, 15 d, 30 d, 2 years after surgery. Subjective evaluation and objective evaluation of Frey＇s syndrome were performed by questionnaire and iodine-starch test 15 d, 30 d, 2 years after surgery. Follow-up for 2 years after surgery was conducted, and correlation of TNF-a levels and Fyey syndrome was analyzed. Results. There were significant differences between the two groups in subjective and objective evaluation at 15 d, 30 d, 2 years （P〈0.01）. The differences in evaluations were significant at different time in observation group （P〈0.01）, while the differences was not significant in control group （P〉0.05）. 2-year follow-up showed no recurrence. There were significant differences between the two groups in TNF-a levels at all time points （P〈0.01）. TNF-a levels showed significant difference at different time（P〈0.01） in observation group, while differences was not significant in control group （P〉0 05）. TNF-a levels had significant correlation with Fyey syndrome （P〈0.05）. Conclusion; Modified surgery can effectively prevent the occurrence of postoperative complications. TNF-a can be used as a indication for preventing Fyey syndrome.