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目的:探讨负压封闭引流技术(vacuum sealing drainage,VSD)在头颈部恶性肿瘤根治重建后下颌下瘘口中应用的可靠性。方法:12例口腔颌面部皮瓣移植修复术后下颌下瘘患者,随机分为试验组和对照组。试验组给予VSD治疗,对照组给予常规换药联合金因肽治疗。结果:试验组治疗1周后拆除负压装置,瘘口收敛,其内充满良性肉芽组织,无渗出。随访4~14个月,瘘口区封闭,愈合良好。对照组经15 d~3个月换药后瘘口封闭。换药期间瘘口不良肉芽组织生长明显,需频繁局部清创。封闭后随访3~21个月,瘘口区愈合。结论:负压封闭引流技术治疗未与口内相通的下颌下瘘口可靠、有效,可缩短住院时间,减轻患者痛苦,减少临床医师的工作量。
Objective: To investigate the reliability of vacuum sealing drainage (VSD) in the submandibular fistula after radical reconstruction of head and neck malignant tumors. Methods: 12 cases of oral and maxillofacial flap were used to repair the submandibular fistula after operation. The patients were randomly divided into experimental group and control group. The experimental group given VSD treatment, the control group given conventional dressing combined with gold peptide treatment. Results: After 1 week of treatment, the negative pressure device was removed and the fistula was closed. The benign granulation tissue was filled in without leakage. Follow-up 4 to 14 months, the fistula area closed, healed well. Control group by 15 d ~ 3 months after the fistula dressing change. Fibrous fistula growth during granulation tissue growth significantly, requiring frequent debridement. After 3 to 21 months of follow-up, the fistula area healed. Conclusion: The negative pressure closed drainage technique is reliable and effective in the treatment of submandibular fistula not communicating with the mouth, which can shorten the length of hospital stay, reduce the pain of patients and reduce the workload of clinicians.