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目的 通过两种改进颈清扫术式MRND与RND和FND术后肩功能的比较研究,观察MRND1和MRND2能否较好地保留或恢复斜方肌的功能。方法46例需行颈清扫术的患者,分成4组,分别行RND、FND和MRND1、MRND2,通过肩功能临床检查的主客观评价标准及斜方肌肌电检测进行对比研究。结果MRND1和MRND2均可获得较大程度的斜方肌功能恢复,MRND1和MRND2的上肢平均最大外展角度分别为96.67°和98.13°,50％的患者外展上臂超过90°,两种改进术式的术后肩功能明显优于RND。结论MRND1和MRND2较FND有广泛的适应证,又可较大程度地保存和恢复术后斜方肌的功能,改善传统RND术后的肩综合征,临床上可以用来代替传统RND,以提高患者的生存质量。
OBJECTIVE: To compare two methods of improving the shoulder function of MRND, RND and FND after neck dissection. To observe whether MRND1 and MRND2 can retain or recover the function of trapezius. Methods Forty-six patients undergoing neck dissection were divided into 4 groups: RND, FND, MRND1 and MRND2 respectively. The subjective and objective evaluation criteria and trapezius myoelectricity test were compared by shoulder function clinical examination. Results Both MRND1 and MRND2 could obtain a greater degree of recovery of trapezius muscle function. The mean maximum abduction angles of upper extremities in MRND1 and MRND2 were 96.67 ° and 98.13 °, respectively, and in 50% of patients, the upper arm outreach was more than 90 °. Postoperative shoulder function was significantly better than RND. Conclusion MRND1 and MRND2 have a wider range of indications than FND, but also to a large extent to preserve and restore postoperative trabecular function and improve the traditional RND shoulder syndrome, clinically used instead of the traditional RND to improve The patient’s quality of life.