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目的:分析腮腺切除术中应用口腔修复膜和胸锁乳突肌瓣预防Frey综合征及面部凹陷性畸形的临床疗效。方法:147例患者随机分为3组,治疗1组51例采用口腔修复膜修复腮腺切除术后创面,治疗2组43例采用胸锁乳突肌瓣修复,对照组53例不做任何修复。三组患者术后随访24个月,比较Frey综合征发生率及患者对面容的满意度并进行统计学分析。结果:治疗1组中3例(3.9%)患者有Frey综合征临床表现,21例(41.2%)患者Minor试验阳性;治疗2组有3例(7.0%)发生Frey综合征,19例(44.2%)Minor’s试验阳性;对照组有23例(43.4%)发生Frey综合征,44例(83.0%)Minor’s试验阳性,比较Minor’s试验阳性率:治疗组与对照组间P<0.05,治疗组间P>0.05。面容满意度分为不满意及满意,三组患者满意度调查不满意者分别为13例(25.5%),2例(4.7%),33例(62.3%);满意者为38例(74.5%),41例(95.3%),20例(37.7%)。三组患者满意度比较:治疗组与对照组间P<0.05,治疗组间P<0.05。结论:腮腺切除术后使用口腔修复膜及胸锁乳突肌瓣修复创面可显著降低Frey综合征的发生率,有效地避免面部凹陷畸形,使用胸锁乳突肌瓣对于避免面部凹陷畸形效果更佳。
Objective: To analyze the clinical effects of oral repair flap and sternocleidomastoid flap in the prevention of frey syndrome and facial deformity in parotid gland resection. Methods: One hundred and seventy-seven patients were randomly divided into three groups. One group treated 51 patients with oral repair membrane repaired the wounds after parotid gland resection. The other two groups were treated by sternocleidomastoid flap in 43 cases and 53 cases in control group without any repair. Three groups of patients were followed up for 24 months, the incidence of Frey’s syndrome and the satisfaction of the patients were compared and analyzed statistically. RESULTS: Frey’s syndrome was found in 3 (3.9%) patients in group 1 and in 21 (41.2%) patients. Frey’s syndrome occurred in 3 (7.0%) and in 19 (44.2 %) Minor’s test positive; 23 cases (43.4%) in the control group had Frey’s syndrome, 44 cases (83.0%) Minor’s test positive, compared with the Minor’s test positive rate: the treatment group and the control group P <0.05, > 0.05. Face satisfaction were divided into dissatisfaction and satisfaction. Thirteen patients (25.5%), two patients (4.7%) and 33 patients (62.3%) were dissatisfied with the three satisfaction groups. Thirty patients (74.5% ), 41 cases (95.3%) and 20 cases (37.7%). Three groups of patients satisfaction comparison: treatment group and control group P <0.05, between the treatment group P <0.05. CONCLUSIONS: The use of oral repair flap and sternocleidomastoid flap for the repair of wounds after parotidectomy can significantly reduce the incidence of Frey syndrome and effectively avoid the facial deformity. The use of sternocleidomastoid flap to avoid facial deformity is more effective good.