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目的探讨肩胛舌骨肌上颈清扫术在口腔癌治疗中的应用价值。方法对27例临床N0(T1~3)口腔鳞状细胞癌患者行肩胛舌骨肌上颈清扫,清扫范围为第Ⅰ、Ⅱ、Ⅲ区淋巴结。记录颈清扫手术时间、术后淋巴结病理检查结果、术后肩功能及随访结果。结果手术时间平均(x±s)为(16±02)h。术后病理检查证实5例出现颈淋巴转移(19%),转移发生于第Ⅰ区2例(7%)、第Ⅱ区4例(15%),其中1例同时存在第Ⅰ、Ⅱ区转移。肩功能在术后3个月内基本恢复。术后随访2~4年,随访率100%,未见原发灶复发及颈淋巴转移。结论肩胛舌骨肌上颈清扫术是临床颈部N0口腔癌的合适术式,它既能达到治疗目的,又能最大程度地保留肩颈部外形与功能。
Objective To investigate the value of scapular hyoid muscle neck dissection in the treatment of oral cancer. Methods 27 cases of clinical N0 (T1 ~ 3) oral squamous cell carcinoma in patients with suprascapular hyoid muscle dissection, the scope of clearance Ⅰ, Ⅱ, Ⅲ regional lymph nodes. The time of neck dissection, postoperative lymph node pathological examination, postoperative shoulder function and follow-up results were recorded. Results The average operation time (x ± s) was (16 ± 02) h. Postoperative pathological examination confirmed 5 cases of cervical lymph node metastasis (19%), the metastasis occurred in 2 cases (7%) of the first area, 4 cases (15%) of the second area, of which 1 case had both metastases . Shoulder function recovered within 3 months after surgery. Follow-up 2 to 4 years after surgery, follow-up rate of 100%, no recurrence of primary tumor and cervical lymph node metastasis. Conclusion Scapular musculocutaneous neck dissection is a suitable method for clinical neck N0 oral cancer. It can not only achieve the therapeutic purpose, but also retain the shape and function of the shoulder and neck as much as possible.