下颌骨边缘性切除术对涉及下颌骨的口腔鳞癌患者的临床疗效研究

Clinical Efficacy of Mandibular Marginal Resection for Oral Squamous Cell Carcinoma Involving Mandible

目的探讨下颌骨边缘性切除术治疗涉及下颌骨的口腔鳞癌患者的临床疗效研究。方法选取涉及下颌骨的口腔鳞癌患者64例,按手术方案不同分为观察组(n=32)和对照组(n=32),对照组予以下颌骨节段切除术,观察组予以下颌骨边缘性切除术。对比两组围术期情况、预后情况、术前、术后1个月Friction颞下颌关节功能紊乱指数(Friction指数)[肌肉压痛指数(PI)、颞下颌关节功能障碍指数(DI)]。结果观察组术中出血量少于对照组,手术时间、住院时间短于对照组(P<0.05);术后1个月,观察组PI、DI评分较对照组低(P<0.05);观察组1年生存率83.33%(25/30)、3年生存率66.67%(20/30)、1年复发率10.00%(3/30)、3年复发率26.67%(8/30)与对照组[80.65%(25/31)、61.29%(19/31)、12.90%(4/31)、29.03%(9/31)]相比无显著差异(P>0.05)。结论采用下颌骨边缘性切除术治疗涉及下颌骨的口腔鳞癌患者,可缩短手术时间,减少出血量,加快患者恢复进程,改善Friction指数,且生存率高,复发率低,可改善预后。

Objective To investigate the clinical effect of marginal mandibular resection in the treatment of oral squamous cell carcinoma involving mandible.Methods 64 cases of oral squamous cell carcinoma involving mandible were selected and divided into the observation group(n=32)and the control group(n=32)according to the different operation schemes.The control group was given segmental resection of mandible,and the observation group was given marginal resection of mandible.The perioperative situation,prognosis,friction index[muscle tenderness index(PI),temporomandibular joint dysfunction index(DI)]before and 1 month after operation were compared between the 2 groups.Results The intraoperative blood loss of the observation group was less than that of the control group,the operation time and hospital stay of the observation group were shorter than those of the control group(P<0.05);the PI and di scores of the observation group were lower than those of the control group 1 month after operation(P<0.05);the 1-year survival rate of the observation group was 83.33%(25/30),the 3-year survival rate was 66.67%(20/30),the 1-year recurrence rate was 10.00%(3/30),and the 3-year recurrence rate was 26.67%(8/30),and those of the control group were 80.65%(25/31),61.29%(1/30),12.90%(4/31)and 29.03%(9/31)(P>0.05).Conclusion Marginal resection of mandible in the treatment of oral squamous cell carcinoma involving mandible can shorten the operation time,reduce the amount of bleeding,accelerate the recovery process of patients,improve the friction index,and improve the prognosis with high survival rate and low recurrence rate.