史堡处型苤圭;!Q!生!旦筮坐鲞筮!!期垦!垫』!!!g:垒!艘塾!Q!!:!!!:坐:№:!!腮腺肿瘤术后Frey综合征预防的初步研究李德志吴跃煌王晓雷刘绍严李正江【摘要】目的探索预防腮腺肿瘤术后Frey综合征发生的临床方法。方法将100例因腮腺肿瘤于2001年至2004年在我院接受腮腺浅叶或全腮腺切除术的患者分为研究组和对照组,每组各50例。研究组在腮腺及肿瘤切除术将结束时,在腮腺术床面神经各分支表面与皮瓣之间插入胶原蛋白片,作为隔离填充,阻止神经错位生长。对照组术中不植入隔离物,其他方面与研究组匹配。术后半年以上,用同一问卷收集患者资料,进行分析评价。结果随访时间为10~39个月,平均16个月。研究组Frey综合征发生率为20%(10/50),对照组为60%(30/50)(X2=15.04,P<0.001),术后颜面轮廓明显凹陷畸形的出现率两组分别为44%和80%(X2=12.26,P<0.001)。结论这种手术方式将Frey综合征的发生率由60%降至20%,为腮腺术后Frey综合征的预防提供了一种简单而有效的方法,同时患者术后颜面轮廓畸形也获得明显改善。【关键词】出汗,味觉性;腮腺肿瘤;外科手术ProspectivecohortstudyonpreventionofFreysyndromeinparotidsurgeryL/De—zhi.耽,rue—huang,WANGXiao—lei,LIUShao—yan,LIZheng-jiang.Departmentof胁以andNeckSurgery,CancerHospital,PekingUnionMedicalCollege,ChineseAcademyofMedicalSciences,Beijing100021,ChinaCorrespondingauthor:WUYne-huang.EmaiZ:yuehuangwu@hotmail.eom【Abstract】ObjectiveToinvestigatethepreventionofFreysyndromeafterparotidectomy.MethodsAprospectivecohoastudyof100patientswithparotidcancerwhoreceivedparotidsurgerywasunderwentinourhospitalfrom2001to2004.Thesepatientswereassignedtotwogroups,studygroup(50cases)andcontrolgroup(50cases).Thepatientsinthestudygroupreceivedparotidectomyandintraoperativeplacementofcollagenpieceswithintheparotidbed,betweentheskinflapandthefacialnerve.Thepatientsinthecontrolgroupreceivedaconventionalparotidectomyandnocollagenpieceswasimplanted.Allofthepatientswerefollowed—upandwereevaluatedforFreysyndromewithidenticalquestionnaires.ResultsCompartedwithcontrolgroup,theincidencerateofFreysyndromeWassignificantlydecreasedinthestudygroup(20%VS60%,x2=15.04,P<0.001).Pos...