腮腺浅叶切除术后单纯负压加压预防涎瘘的效果评价

The effect evaluation of suction drainage to prevent fistula after superficial parotidectomy

目的：评价单纯负压引流在腮腺手术后涎瘘预防中的临床价值,根据术后引流量、引流天数与涎瘘的关系,寻找最佳的拔管时机。方法：不保留腮腺导管的腮腺浅叶切除的腮腺疾病患者194例,分为传统加压组（拔除引流管后继续加压包扎）和单纯负压组（拔管后不再加压包扎）,记录术后涎瘘情况。应用SPSS19.0软件包对数据进行统计学分析。结果：传统加压组涎瘘发生率（11.6%）与单纯负压组涎瘘发生率（15.5%）无显著差异（P〉0.05）;单纯负压组,引流天数与涎瘘发生率无显著相关性（P〉0.05）,而引流量少于20 m L的患者,术后涎瘘发生率显著低于20-30 m L者。结论：单纯负压引流能代替传统拔管后继续加压包扎预防涎瘘,引流量小于20 m L可作为拔管的最佳时机。

PURPOSE： To evaluate the clinical value of suction drainage to prevent fistula after parotidectomy, and seek the best opportunity to remove the drainage according to the draining output and duration. METHODS： One hundred and ninety-four patients with parotid diseases after superficial parotidectomy were assigned into pressure dressing group and suction drainage group. Pressure dressing was used after suction drainage tube was removed in the pressure group, while suction drainage tube was fixed through the process in the suction group. Postoperative salivary fistula occurrence between the 2 groups was analyzed with Pearson chi-square test, and the contribution of the output and duration resulting in salivary fistula was analyzed by Fisher＇s exact test with SPSS 19.0 software package. RESULTS： The occurrence of salivary fistula in the pressure dressing group and suction group was 11.6% and 15.5%, respectively in the suction group. No significance difference was found between the 2 groups （P〉0.05）. In the suction drainage group, significant correlation of the draining duration and salivary fistula was not found （P〉0.05）. However, the draining output less than 20 mL resulted in lower salivary fistula rate compared with the draining output of 20-30 mL. CONCLUSIONS： According to our findings, suction drainage can be used as a substitute for pressure dressing after parotidectomy in preventing salivary fistula, and the best timing of drainage extubation is when the draining output is less than 20 mL within 24 hours.