【作者】 张振林；

【导师】 农东晓；

【作者基本信息】 广西医科大学 ， 耳鼻咽喉头颈外科， 2011， 硕士

【摘要】 目的:本研究通过对头颈部肿瘤患者术后颈部术区超声检查了解有无积液存在,协助临床诊治,早期发现并发症,减少危害。方法:分析34例头颈肿瘤患者术后术区彩色超声检查情况,并将其分为积液组与非积液组。分析病种手术类型、肿瘤分期、合并糖尿病患者、手术时长、颈淋巴结清扫术与肌皮瓣转移修复术、术后引流管放置时长及术后超声检查时间与积液的相关性,探讨积液对患者术后住院时间及咽瘘的影响价值。结果:咽腔开放手术与喉腔开放手术患者比较术后颈部积液的发生率有统计学差异(P<0.05)。患者肿瘤分期、颈淋巴结清扫、肌皮瓣转移修复、手术时长、引流管放置时间及术后行超声检查时间在两组中差异无统计学意义(P>0.05)。合并糖尿病患者在术后积液及咽瘘的发生率中有统计学差异(P<0.05)。两组患者咽瘘发生率及术后住院时间差异有统计学意义(P<0.05)。结论:行咽腔开放手术肿瘤切除患者术区积液的发生率比喉腔开放性手术患者大;合并糖尿病的头颈部肿瘤患者术后颈部易积液同时并发咽漏的机会大;头颈部肿瘤术后拔除引流管后超声检查提示有积液的患者术后住院时间可能会延长同时发生咽瘘的风险高;头颈部肿瘤术后术区彩色超声检查是安全、有效的,能快速了解术区积液情况,协助临床诊治。更多还原

【Abstract】 Objectve In order to prvent postoperative complications, evaluation of postoperative ultrasonic inspection on effusion in surgical region after head and neck surgeries was performed.Methods 34 surgical cases with head and neck cancer were divided into effusion group and non- effusion group based on the results of postoperative ultrasonography. Rates of effusion was studied according to the following potential predictors: surgery performed, tumor stage, patients with diabetes mellitus, duration of surgery, neck dissection,muscle flap repairation, duration of postoperative drainage and the time of postoperative ultrasonograhy . In addition, the effusion influences on postoperative hospital stay and pharyngeal fistula are also discussed.Results There was statistically significance in the incidence of postoperative effusion beteeen the surgeries of pharyngeal cavity opening and laryngeal cavity opening(P<0.05). No statistical significancant influecnces on effucion were found concerning the factors of tumor stage, neck dissection , myocutaneous flap repairation, duration of sugery, duration of postoperative drainage and the time of postoperative ultrasonograhy(P>0.05). Diabetes acted as a significant factor in postoperative effusion and pharyngeal fistula (P<0.05). Postoperative effusion significantly increased the rate of pharyngeal fistula and the duration of postoperative hospital stay.Conclusion Patients with a pharyngeal cavity opening surgery showed a higher incidence of postoperative effusion than the others who had surgeries of laryngeal cavity; Patients with diabetes may have a higher opportunity of postoperative effusion and pharyngeal fistula; Patients who were foud effusion in the postoperative region by ultrasonograhy after removing drainage tube will have a longer hospital stay as well as higher risk of pharyngeal fistula. Color ultrasonography used in the postoperative region of head and neck is a safe and effective examination in diagnosis and management of postoperative effusion.更多还原