微波固化治疗在口腔癌中的临床应用——附96例临床总结

Application of Microwave Coagulation in Treatment of Cancer of Oral Cavity:Summary of 96Cases

背景与目的:微波固化治疗口底癌在保护口腔功能方面的研究较少。本研究旨在探讨微波固化治疗过程中的两种特殊处理方式的意义及出血的预防。方法:回顾性分析经微波固化治疗的96例口腔癌病例,比较清除的固化组织病理学检查阴性组和阳性组生存曲线和复发率,比较手术切缘组织病理学阴性组和阳性组的生存曲线和复发率,分析微波固化的并发症及其防治。结果:固化组织病理学检查阴性组和阳性组生存曲线的差异无统计学意义(Log-rank=0.70,P=0.4033),原发灶、继发灶和复发灶不明者复发率的差异也无统计学意义(χ2=1.650,0.837,0.003;P=0.684,0.360,0.959);手术切缘组织病理学阴性组的总体生存时间高于阳性组(Log-rank=6.08,P=0.0136),但复发率的差异则无统计学意义(χ2=0.327,P=0.567);96例患者的总体并发症发生率为9.6%,都是可以接受的,微波固化组织清除组的出血发生率较微波固化组织未清除组的低(P=0.013)。结论:舌动脉结扎、固化组织清除、创缘缝扎碘仿纱压迫是防止术后出血的有效方法,但微波固化组织的病理学检查结果对预后没有预测作用。术中宜确保足够的固化治疗范围。微波固化治疗口底癌时并发症少且较轻微。

BACKGROUND &OBJECTIVE:There was few report about the protection of oral function of micro wave coag ulation in treatment of cancer of floor of the mouth.This study was desig ned to systematically clarify the principle,operation,treatment of the primary cancer and lymph nodes ,efficiency,function of the mouth,complications and indications of the microwave coag ulation in treatment of the cancer of the oral cavity.Based on this,t he sig nificance of the two special meth ods and prevention of bleeding durin g the cause were discussed.METHODS :Ninety-six cases with cancer of oral cavity who were treated with microwave coag ulation were analyzed retrospectiv ely.The survival rates and the recurrent rat es of those with the coag ulated tissu e be resected or unresected,and of the po sitive marg in g roup and the neg ative marg in g roup were compared for analy zing the complications and prevention of them.RESULTS:The difference of the survival rate s of those whose coag ulated tissue patholog ically positive and neg ative was insig nificant (Log Rank =0.70,P=0.4033),and the differences of the recurren t rates of the primary site,secondary site and the uncertain sit e of them were also insig nificant (χ 2 =1.65,0.837,0.003;P=0.684,0.36,0.959).The overall survival rate of the pat ients with neg ative marg in was better than those of with positive marg in(Log Rank =6.08,P=0.0136).However,the difference of the recurrent rates of them was insig nificant (χ 2 =0.327,P=0.567).The total complication rate of 96pa tients was 9.6%and all of them were acceptab le.The complication rate of those wi th the coag ulated tissue be resected wa s lower than that of the unresected(P=0.013).CONCLUSION:Lig ating the tong ue artery,resecting the coag ulated tissue,and packing the wound marg in were effective methods to prevent th e bleeding .The patholog ical result o f the coag ulated tissue could not be u sed to predict the prog nosis.It is best to h old enoug h treatment rang e for micro wave coag ulation.Application of microw ave coag ulation in treatment of cancer of oral cavity has the advantag e of less and s lig ht complications.