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目的:探讨口腔癌术中预防口底瘘下颌骨内侧牙龈处理手术方法的改进。方法:回顾性分析181例行原发灶-(颌)-颈联合根治术的口腔癌病例,所有患者均采用薄的往复锯离断下颌骨。分析离断及重建过程中牙龈、黏膜微创处理方式,并观察术后口底瘘的发生率。结果:181例病例中,皮瓣存活180例;伤口Ⅰ期愈合179例,口底感染1例,口底瘘1例。结论:在需处理下颌骨的口腔癌根治术中,通过对下颌骨内侧牙龈处理方式的改进,可减少牙龈组织的创伤,降低操作难度,完整封闭口底并有效预防术后口底瘘的发生。
Objective: To discuss the improvement of surgical methods for preventing gingiva in the mouth and mouth of oral fistula during oral operation. Methods: A retrospective analysis of 181 cases of primary tumor - (jaw) - cervical radical mastectomy cases of oral cancer, all patients with a thin reciprocating saw off the mandible. The methods of minimally invasive treatment of gums and mucosa in the process of transection and reconstruction were analyzed, and the incidence of postoperative fistula was observed. Results: In 181 cases, the flap survived in 180 cases. The wounds were healed in the first stage, 179 cases were infected by the mouth, 1 case was the fistula at the mouth. Conclusion: In the treatment of mandibular oral cancer, the treatment of the medial gingival of mandible can reduce the trauma of gingival tissue, reduce the difficulty of operation, completely close the mouth and effectively prevent the occurrence of postoperative fistula .