CAJ | 학술논문

目的：将面神经解剖技术应用于腮腺手术治疗中，并观察其临床应用效果。方法对比分析法是对应用顺行法与逆行法在实施腮腺手术的患者临床资料进行分析的一种方法，本文采用这种方法对我院自2011年3月至2013年3月收治的80例病患资料进行临床分析，按照随即抽取法将其分为A组与B组，其中A组患者应用顺行法（即通过找出面神经总干再分离各分支的方法）进行治疗，B组患者应用逆行法（即通过找出下颌缘支再经由其他分支找到主干的方法）进行治疗，每组患者各40例。结果A组与B组两种面神经解剖方法在腮腺手术中均取得了良好的临床解剖效果，对面部神经起到了很好的保护作用，其中A组神经功能损伤发生率为7.5%，B组神经功能损伤发生率为5%，两组术式治疗数据不存在明显差异，无具有统计学意义（P＞0.05）。除了切断恶性肿瘤侵犯面神经以外，没有一例病患出现面神经离断而导致的永久性面神经损伤，出现轻度的下颌缘支受损的症状的患者有3例，出现颧支及颞支受损的症状的患者各有1例，随访3～6个月后，患者病症基本恢复。结论采用两种方法进行面神经解剖，具有良好的临床治疗效果，但是A组手术恢复时长明显短于B组，如果将两种方法相结合，则会起到保护面神经的作用，从而降低面神经的损伤率。
목적：장면신경해부기술응용우시선수술치료중，병관찰기림상응용효과。방법대비분석법시대응용순행법여역행법재실시시선수술적환자림상자료진행분석적일충방법，본문채용저충방법대아원자2011년3월지2013년3월수치적80례병환자료진행림상분석，안조수즉추취법장기분위A조여B조，기중A조환자응용순행법（즉통과조출면신경총간재분리각분지적방법）진행치료，B조환자응용역행법（즉통과조출하합연지재경유기타분지조도주간적방법）진행치료，매조환자각40례。결과A조여B조량충면신경해부방법재시선수술중균취득료량호적림상해부효과，대면부신경기도료흔호적보호작용，기중A조신경공능손상발생솔위7.5%，B조신경공능손상발생솔위5%，량조술식치료수거불존재명현차이，무구유통계학의의（P＞0.05）。제료절단악성종류침범면신경이외，몰유일례병환출현면신경리단이도치적영구성면신경손상，출현경도적하합연지수손적증상적환자유3례，출현권지급섭지수손적증상적환자각유1례，수방3～6개월후，환자병증기본회복。결론채용량충방법진행면신경해부，구유량호적림상치료효과，단시A조수술회복시장명현단우B조，여과장량충방법상결합，칙회기도보호면신경적작용，종이강저면신경적손상솔。
Objective The facial nerve dissection techniques used in the surgical treatment of parotid and observe its clinical application. Methods A comparative analysis is on the application of anterograde and retrograde approach in the implementation of Law parotid surgery clinical data analysis method, we use this method in our hospital from March 2011 - March 2013 were treated 80 cases clinical analysis of patient data, in accordance with the law will be randomly selected and divided into group A, group B, group A patients antegrade approach (ie, by identifying and then separating the facial nerve branches total dry method) for treatment, B group patients with retrograde method (ie by ifnding the marginal mandibular branch to ifnd the trunk and then through the other methods) for treatment, 40 patients in each group of patients. Results A group and B group two kinds of facial nerve in parotid gland surgery methods have achieved good results in clinical anatomy of the facial nerve has played a very good protection, where A group of neurological injury rate 7.5%, B group neurological injury rate of 5%, two surgical treatment of the data is not signiifcantly different, no statistically signiifcant(P>0.05). Apart from cutting malignant tumors invading the facial nerve, which no one cases of patients present with facial nerve transection caused permanent facial nerve injury, a mild damage to the marginal mandibular branch of the patients had symptoms of three cases, there zygomatic and temporal branch damage symptoms have one case, follow-up 3~6 months later, the patient illness recovered. Conclusion The use of two methods for facial nerve, has a good clinical effect, but the A group, the length of recovery operation was shorter in group B, if the combination of the two methods, will play the role of protecting the facial nerve, thereby reducing the facial nerve damage rates.