医用即溶止血纱布在腮腺手术后的应用效果

Application efficacy of medical absorbable hemostatic gauze in parotid gland surgery

目的探讨医用即溶止血纱布在腮腺良性肿瘤切除术后的止血效果及其对味觉出汗综合征(Frey综合征)预防作用。方法回顾性分析2012年1月至2015年6月于南京鼓楼医院行腮腺浅叶切除+面神经解剖术的良性肿瘤病例共51例临床资料,将术后使用医用即溶止血纱布的患者29例设为试验组,未使用医用即溶止血纱布的22例设为对照组,统计分析术后引流液量、愈合等级,并对两组患者术后随访8~50个月,比较Frey综合征发生率。结果两组创面均为甲级愈合,试验组中术后血性引流量为15~160 mL,平均(61.7±47.9)mL;对照组血性引流量为30~240 mL,平均(119.1±37.0)mL,差异有统计学意义(P<0.05)。试验组与对照组患者Frey综合征发生率分别为20.8%(5/29)、50.0%(11/22),差异有统计学意义(P<0.05)。结论腮腺术中应用医用即溶止血纱布止血有效,且能够有效减少腮腺术后Frey综合征的发生,具有临床推广应用价值。

Objective To discuss the hemostatic effect of medical absorbable hemostatic gauze after resection of the parotid gland benign tumor and its prevention effect on gustatory sweating syndrome （Frey syndrome）. Methods The clinical data of 51 patients with pa-rotid benign tumors, underwent superficial parotidectomy with facial nerve dissection in our hospital from Jan 2012 to Jun 2015, were retro-spectively analyzed. The patients who were given medical absorbable hemostatic gauze after operation were enrolled as the study group （ 29 cases） , and other 22 cases of non-users were enrolled as the control group. The volume of drainage liquid and grade of incision healing in all patients were recorded and analyzed, and after following up for 8~50 months, the incidence rate of Frey syndrome in the two groups was evaluated with an identical questionnaire and compared. Results All the incisions healed up in first grade. The volume of bloody drainage was 15~160 mL in the study group with an average of （61. 7 ± 47. 9） mL, and it was 30~240 mL in the control group with an average of （119. 1 ± 37. 0） mL, with significant difference between them （P〈0. 05）. There was also significant difference in the incidence rate of Frey syndrome between the study group and the control group （20. 8% vs 50. 0%;P〈0. 05）. Conclusion The application of medical absorba-ble hemostatic gauze in the parotidectomy would be effective to reduce postoperative bleeding and prevent the occurrence of Frey syndrome, and is worthy of clinical application and expansion.