【作者】 江涛；

【导师】 刘业海；

【作者基本信息】 安徽医科大学 ， 耳鼻咽喉科学， 2025， 硕士

【摘要】 目的:腮腺良性肿瘤是常见的头颈部肿瘤,其外科治疗在确保肿瘤切除彻底性的同时,需兼顾功能保留与美观效果。本研究旨在比较V型切口与改良Blair切口在腮腺良性肿瘤切除手术中的临床应用效果,评估这两种不同切口在术后恢复、并发症发生率及患者满意度等多个关键指标的差异,以期为腮腺手术切口选择提供临床依据。方法:回顾性队列研究设计,收集2022年9月-2024年1月于安徽医科大学第一附属医院就诊的60例腮腺良性肿瘤手术患者,按照切口类型的不同分为实验组(V型切口组)和对照组(改良Blair切口组)。对比分析了两组在手术时间、术后引流量、术后住院时间、术后并发症(如面瘫、耳垂麻木、涎瘘、Frey综合征)及患者自体满意度和疤痕评分的差异。数据采用Graph Pad Prism 9.0统计软件进行分析,当P<0.05时,其差异具有统计学意义。结果:研究结果显示,两组患者在性别,年龄,肿瘤直径,病理类型等基线特征上无显著差异(P>0.05),具有可比性。其中两组的手术时长,术后引流量等指标中均无统计学差异(P>0.05)。但实验组术后住院时间显著短于对照组(4.13天vs 5.03天),具有统计学差异(P<0.05)。在术后1年随访中,常见的术后并发症的发生率如面瘫、耳垂麻木、涎瘘、Frey综合征等,实验组与对照组间均无明显统计学差异(P>0.05),但在术后1周时,实验组面瘫分级显著低于对照组(2.29±0.49vs.2.88±0.62),具有统计学差异(P<0.05)。此外,在术后一年的时间中,实验组在疤痕长度、医生评分及患者满意度方面均显著优于对照组,有统计学差异(P<0.05),患者主观满意度评分亦随随访时间延长显著提高。结论:本研究证实,实验组手术方式在保证肿瘤治疗效果的前提下,可显著缩短术后住院时间,减轻早期面瘫严重程度,并显著改善疤痕外观及患者满意度,且未增加并发症或复发风险。相较于改良Blair切口更具临床优势。因此,V型切口是一种值得推广的腮腺良性肿瘤手术入路方式,具有较高的临床推广价值。更多还原

【Abstract】 Objective:Benign parotid tumors are common head and neck neoplasms.Surgical treatment must balance tumor eradication with functional preservation and aesthetic outcomes.This study aims to compare the clinical efficacy of V-shaped and modified Blair incisions in parotid benign tumor resection,focusing on postoperative recovery,complication rates,and patient satisfaction,to provide clinical guidance for incision selection.Methods:A retrospective cohort study was conducted to collect 60 patients with benign parotid tumor surgery who were admitted to the First Affiliated Hospital of Anhui Medical University from September 2022 to January 2024,and were divided into experimental group(V-shaped incision group)and control group(modified Blair incision group)according to different incision types.The differences in operation time,postoperative drainage,postoperative hospital stay,postoperative complications(such as facial paralysis,earlobe numbness,salivary fistula,Frey syndrome),self-satisfaction and scar scores between the two groups were compared and analyzed.The data were analyzed using Graph Pad Prism 9.0 statistical software,and the difference was statistically significant when the P<0.05 was 0.05.Results:The results showed that there were no significant differences in baseline characteristics such as gender,age,tumor diameter,and pathological type between the two groups(P>0.05),which was comparable.There were no statistically significant differences in operation duration and postoperative drainage volume between the two groups(P>0.05).However,the postoperative hospital stay in the experimental group was significantly shorter than that in the control group(4.13 days vs.5.03 days),and there was a statistical difference(P<0.05).At the one-year follow-up after surgery,there was no significant difference in the incidence of common postoperative complications such as facial paralysis,earlobe numbness,salivary fistula,Frey syndrome,etc.between the experimental group and the control group(P>0.05),but at 1 week after surgery,the classification of facial paralysis in the experimental group was significantly lower than that in the control group(2.29±0.49 vs.2.88±0.62),and there was a statistical difference(P<0.05).In addition,the experimental group was significantly better than the control group in terms of scar length,doctor score and patient satisfaction during the one year after surgery(P<0.05),and the subjective satisfaction score of patients also increased significantly with the extension of follow-up time.Conclusion:The V-shaped incision significantly reduced hospital stay,alleviated early facial paralysis severity,improved scar aesthetics,and enhanced patient satisfaction without increasing complications or recurrence risks.Compared to the modified Blair incision,the V-shaped incision offers greater clinical advantages and is a promising approach for parotid benign tumor resection.更多还原