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目的探讨改良肩胛舌骨上颈淋巴结清扫术(MSOHND)与传统肩胛舌骨上颈淋巴结清扫术(CSOHND)对N_0期口腔癌的治疗效果。方法选取N0期口腔癌患者100例,根据手术方法不同将患者分为MSOHND组(n=55)和CSOHND组(n=45),比较两组患者的手术一般情况、肩关节功能恢复情况及生活质量,分析两组患者术后1年生存率和转移率的差异。结果两组患者的手术时间、术中出血量比较,差异无统计学意义(P﹥0.05);MSOHND组患者术后1个月和术后3个月时的肩部疼痛得分明显低于CSOHND组(P﹤0.001),外展角度明显大于CSOHND组(P﹤0.001);手术前,两组患者的生活质量比较,差异无统计学意义(P﹥0.05);手术后,MSOHND组患者术后面容外形、活动能力、消遣娱乐等生活质量得分均较CSOHND组高(P﹤0.05);两组患者术后1年生存率、转移率比较,差异均无统计学意义(P﹥0.05)。结论 MSOHND对N_0期口腔癌具有较好的治疗效果,可明显改善患者术后肩关节功能,提高患者术后生活质量。
Objective To investigate the therapeutic effects of modified supraomohyoid supraspinous lymph node dissection (MSOHND) and conventional supraomohyoid supraspinatus lymph node dissection (CSOHND) on N0 oral cancer. Methods 100 patients with stage N0 oral cancer were enrolled in this study. Patients were divided into MSOHND group (n = 55) and CSOHND group (n = 45) according to different operative methods. The general operation, shoulder functional recovery and life Quality, analysis of two groups of patients after 1-year survival rate and metastasis rate differences. Results There was no significant difference in operative time and blood loss between the two groups (P> 0.05). The scores of shoulder pain at 1 month and 3 months after operation in MSOHND group were significantly lower than those in CSOHND group (P0.001), and the abduction angle was significantly higher than that of CSOHND group (P0.001). There was no significant difference in quality of life between the two groups before surgery (P> 0.05). After operation, the postoperative appearance of patients in MSOHND group Quality of life, appearance, activity ability, entertainment and other quality of life scores were higher than those of CSOHND group (P <0.05). There was no significant difference in one-year survival rate and metastasis rate between the two groups (P> 0.05). Conclusion MSOHND has a good therapeutic effect on N0 stage oral cancer, which can significantly improve postoperative shoulder joint function and improve postoperative quality of life.