不同手术切口对腮腺良性肿瘤患者血清疼痛介质、氧化应激的影响

Effects of Different Surgical Incision on Serum Pain Mediators and Oxidative Stress in Patients with Benign Tumors of Parotid Gland

目的分析不同手术切口对腮腺良性肿瘤患者血清疼痛介质、氧化应激的影响。方法回顾性分析2016年1月至2023年1月在赞比亚Ndola教学医院、赞比亚恩都拉铜带大学教学医院、河南省人民医院、河南科技大学第二附属医院接受腮腺良性肿瘤切除手术治疗的65例腮腺良性肿瘤患者临床资料,按照手术切口分为对照组(40例,术中接受传统S形切口操作)、观察组[25例,术中行改良耳前-耳后发际切口(又称改良V形切口)]。对比两组手术指标、术区面神经损伤情况、血清疼痛介质、氧化应激指标、手术瘢痕情况、并发症发生率。结果观察组手术用时、术后引流量与对照组相比,差异无统计学意义(P>0.05);观察组术中出血量比对照组少(P<0.05);观察组术后第7天House-Brackmann分级法评分、超氧化物歧化酶、谷胱甘肽过氧化物酶比对照组高,血清前列腺素E 2、P物质、β-内啡肽水平比对照组低(P<0.05);观察组术后第1个月瘢痕美容评估与评级量表评分比对照组高(P<0.05);观察组并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论与传统S形切口操作相比,实施改良V形操作可有效减少术中出血量,减轻面部神经损伤程度,降低术后疼痛及氧化应激反应程度,改善手术瘢痕情况。

Objective To analyze the effects of different surgical incision on serum pain mediators and oxidative stress in patients with benign tumors of parotid gland.Methods The clinical data of 65 patients with benign tumors of parotid gland who underwent surgical resection at Ndola Teaching Hospital in Zambia,Ndola Copper Belt University Teaching Hospital in Zambia,and the Second Affiliated Hospital of Henan University of Science and Technology,Henan Provincial People’s Hospital in China from January 2016 to January 2023 were retrospectively analyzed.The patients were divided into two groups according to surgical incision:the control group(40 cases,received traditional S-shaped incision during operation)and the observation group[25 cases,received modified ear-front-to-ear-back hairline incision(also known as modified V-shaped incision)].The surgical indicators,facial nerve injury,serum pain mediators,oxidative stress indicators,surgical scar and complication rates were compared between the two groups.Results The operation time and postoperative drainage volume in the observation group were similar to those in the control group(P>0.05).The amount of bleeding in the operation in the observation group was less than that in the control group(P<0.05).In the observation group,the House-Brackmann grading score,superoxide dismutase,glutathione peroxidase were higher than those in the control group on the 7th day after surgery,while the levels of prostaglandin E 2,substance P,β-endorphin in serum were lower(P<0.05).The scar beauty assessment and rating scale score in the observation group was higher than that in the control group on the 1st month after surgery(P<0.05).The incidence of complications in the observation group was similar to that in the control group,with no significant difference(P>0.05).Conclusion Compared with the traditional S-shaped incision operation,the modified V-shaped operation can effectively reduce intraoperative blood loss,alleviate the degree of facial nerve injury,reduce postoperative pain and oxidative stress reaction degree,and improve surgical scar condition.