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目的探讨超声刀在老年腮腺肿瘤手术中的临床应用价值和安全性。方法回顾性分析2010年1月—2014年1月收治的62例60岁以上老年腮腺肿瘤患者,其中超声刀组32例、传统电刀组30例,记录并比较2组患者总手术时间、切除腮腺浅叶的时间、术中总出血量、术后24 h引流量、术后总引流量、住院时间、引流管留置时间、住院费用、术后VAS评分和有无并发症。结果超声刀组与传统电刀组比较,总手术时间(min):58.8±10.1 vs.79.3±13.1(t=-6.897,P<0.001),切除腮腺浅叶的时间(min):42.7±9.9 vs.61.3±15.7(t=-5.559,P<0.001);术中总出血量(ml):14.1±5.0 vs.23.7±5.6(t=-7.166,P<0.001);术后24 h引流量(ml):19.5±4.8 vs.36.7±9.2(t=-9.083,P<0.001);术后总引流量(ml):43.1±6.9 vs.90.7±10.8(t=-20.756,P<0.001);住院时间和引流管留置时间2组比较差异有统计学意义;术后第2天VAS评分,差异有统计学意义(P<0.01)。2组住院费用差异无统计学意义。局部并发症和全身其他系统并发症,差异均无统计学意义(P>0.05)。结论超声刀在老年腮腺肿瘤手术中的应用是安全有效的,具有手术创伤小、术中出血少、术后渗出少及术后恢复快等优点,值得推广应用。
Objective To investigate the clinical value and safety of ultrasonic knife in elderly patients with parotid tumor. Methods A retrospective analysis of 62 patients aged 60 years and older with parotid gland tumors admitted to our hospital from January 2010 to January 2014 included 32 cases of ultrasound knife group and 30 cases of traditional electric knife group. The total operation time and the resection rate Parotid shallow leaves, total intraoperative blood loss, postoperative 24 h drainage, postoperative total drainage, hospital stay, drainage tube indwelling time, hospitalization costs, postoperative VAS score and the presence or absence of complications. Results The total operative time (min) was 58.8 ± 10.1 vs.79.3 ± 13.1 (t = -6.897, P <0.001). The time of removal of parotid shallow leaves was 42.7 ± 9.9 vs.61.3 ± 15.7 (t = -5.559, P <0.001). The total amount of blood loss during operation was 14.1 ± 5.0 vs.23.7 ± 5.6 (t = -7.166, P <0.001) (ml): 19.5 ± 4.8 vs.36.7 ± 9.2 (t = -9.083, P <0.001). The total drainage volume after operation was 43.1 ± 6.9 vs.90.7 ± 10.8 (t = -20.756, There was significant difference between the two groups in hospitalization time and drainage tube indwelling time. The VAS score on the second day after operation was significantly different (P <0.01). There was no significant difference in hospitalization costs between the two groups. Local complications and other systemic complications of the whole body, the difference was not statistically significant (P> 0.05). Conclusion Ultrasound knife in elderly patients with parotid tumor surgery is safe and effective, with less trauma, less bleeding, less postoperative exudation and postoperative recovery, etc., it is worth to promote the use.