Application of harmonic scalpel in surgery for parotid gland tumor in the elderly patients
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摘要: 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。Abstract: Objective To investigate the clinical value of harmonic scalpel in surgery for parotid gland tumor in the elderly patientsand its safety. Methods A retrospective analysis was made on clinical date of 62 cases of parotid neoplasms aged 60 or over in our hospital from Jan. 2010 to Jan. 2014,among them 32 cases undergoing surgery with harmonic scalpel(harmonic scalpel group) and 30 patients undergoing with traditional electrosurgicalscalpel(traditional electrosurgicalscalpel group).The total operation time,time for cutting off superficial lobe,intraoperative blood loss,24 hours volumeof postoperative drainage,total volume of postoperative drainage,length of hospital stay,drainage time,the cost of hospitalization,postoperative VAS and incidence of complication of both groups were observed and compared. Results The total operation time(min),time for cutting off superficial lobe(min),intraoperative blood loss(ml),24 hours volume ofpostoperative drainage(ml),total volume of postoperative drainage(ml),length of hospitalstay(d),drainage time(d),and postoperative VAS within 2 days of the 2 groups were 58.8±10.1 vs. 79.3±13.1(t=-6.897,P<0.001),42.7±9.9 vs. 61.3±15.7(t=-5.559,P<0.001),14.1±5.0 vs. 23.7±5.6(t=-7.166,P<0.001),19.5±4.8 vs. 36.7±9.2(t=-9.083,P<0.001),43.1±6.9 vs. 90.7±10.8(t=-20.756,P<0.001),5.4±0.5 vs. 7.4±0.7(t=-13.431,P<0.001),3.5±0.5 vs. 5.6±0.7(t=-13.776,P<0.001) and 2.4±0.8 vs.3.1±0.9(t=-3.251,P=0.002),respectively,and the difference was statistical significant(P<0.01).The cost of hospitalization(yuan),localcomplicationand other system complication of the 2 groups were 7 615.6±278.4 vs. 7 700.0±271.6(t=-1.207,P=0.232),1 vs. 3(χ2=0.341,P=0.559) and 10 vs. 14(χ2=1.551,P=0.213),respectively,and the difference was not statistical significant(P>0.05). Conclusion The harmonic scalpel in surgery for parotid gland tumor in the elderly patients is safe and effective.The advantagesincludeshorter time of surgery,less intraoperative blood loss,less postoperative drain output and quicker recover.It is worth to be further promoted in clinical.
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Key words:
- Old patients /
- Parotid tumors /
- Harmonic scalpel /
- Surgery therapy
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