CAJ | 학술논문

背景:针对口腔颌面部肿瘤扩大切除术同时行颈部淋巴结清扫术中并发乳糜瘘的问题.很多专家学者有不同的处理方式,单纯的手术结扎、强负压引流或者是单纯的肌肉组织填塞或者以上方法的组合,在预后及治疗效果上存在或多或少的缺陷.目的:评价颈部淋巴清扫术中采用医用生物胶黏合周围自体肌肉组织封堵胸导管瘘口以预防术后乳糜瘘的疗效.方法:12例口腔癌患者在颈淋巴清扫术中发现并确诊为乳糜瘘后,立即行瘘口缝扎并应用医用生物胶黏合周围自体肌肉组织封堵瘘口.结果与结论:10例患者术中经此方法治疗后术后未出现乳糜瘘及其他严重并发症;2例患者经此法治疗无效后,二次手术探查行瘘口缝扎及应用医用生物胶黏合封堵治疗后有效.术后随访所有12例患者3个月均未发现有乳糜瘘复发,亦未出现局部刺激反应及变态反应.结果表明术中医用生物胶黏合封堵胸导管瘘口是预防颈淋巴结清扫术后乳糜瘘理想、安全的治疗方法.
배경:침대구강합면부종류확대절제술동시행경부림파결청소술중병발유미루적문제.흔다전가학자유불동적처리방식,단순적수술결찰、강부압인류혹자시단순적기육조직전새혹자이상방법적조합,재예후급치료효과상존재혹다혹소적결함.목적:평개경부림파청소술중채용의용생물효점합주위자체기육조직봉도흉도관루구이예방술후유미루적료효.방법:12례구강암환자재경림파청소술중발현병학진위유미루후,립즉행루구봉찰병응용의용생물효점합주위자체기육조직봉도루구.결과여결론:10례환자술중경차방법치료후술후미출현유미루급기타엄중병발증;2례환자경차법치료무효후,이차수술탐사행루구봉찰급응용의용생물효점합봉도치료후유효.술후수방소유12례환자3개월균미발현유유미루복발,역미출현국부자격반응급변태반응.결과표명술중의용생물효점합봉도흉도관루구시예방경림파결청소술후유미루이상、안전적치료방법.
BACKGROUND: As for the treatment of chylous fistula concurrent in oral-maxillofacial tumor resection simultaneously undergoing neck lymph node dissection, many different approaches have been put forward. A simple surgical ligation, strong negative pressure drainage, filling the muscle tissue alone or a combination of the above methods are all unsatisfactory regarding the prognosis and curative effect.OBJECTIVE: To evaluate the validity of medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula in order to prevent chylous fistula following neck lymph node dissection.METHODS: All of the 12 patients were detected and diagnosed as chylous fistula in neck lymph node dissection surgery, the wounds were immediately sutured and treated with medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula. RESULTS AND CONCLUTION: Of all the 12 patients, 10 recovered without chylous fistula or severe complications, and reoperations were adopted to cure the failed 2 cases. All patients were visited 3 months postoperatively, no recurrence of chylous fistula, local stimulus response or allergy was found. It is suggested medical adhesive to block thoracic duct fistula may be an effective and safe way for prevent chylous fistula following neck lymph node dissection.