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目的探讨舌-口底-颈部垂直连续切除在根治口腔粘膜下纤维性变舌癌变中临床意义。方法收集2004年1月-2008年8月间口腔粘膜下纤维性变舌癌变患者60例(原发灶T2或T3),同期行舌颈联合根治术,术中沿舌部原发灶外安全范围垂直切除至舌骨水平,并沿下颌骨内侧牙龈切开,将舌、口底及颈部淋巴组织作连续切除。同期收集另外一组未行垂直连续切除的口腔粘膜下纤维性变舌癌变患者临床资料54例,比较两组患者间复发率与颈部转移率。结果实验组局部无复发,对侧颈部转移9例,转移率15%。对照组局部复发18例,对侧颈部转移9例,复发转移率50%。差异有统计学意义(P<0.05)。结论舌-口底-颈部垂直连续切除可以明显提高口腔粘膜下纤维性变舌癌变患者临床治疗效果,值得推荐。
Objective To investigate the clinical significance of tongue-mouth-neck vertical continuous excision in the treatment of oral carcinogenesis of oral submucosal fibrosis. Methods Sixty patients (T2 or T3) with oral submucosal fibrosis and tongue cancer were collected during the period from January 2004 to August 2008. Tongue and neck radical mastectomy was performed at the same time. The range of vertical resection to the hyoid level, and along the medial mandibular gingival incision, the tongue, mouth and neck lymphoid tissue for continuous removal. In the same period, another group of 54 patients with oral submucous fibrosis tongue cancer without continuous vertical resection were collected. The recurrence rate and neck metastasis were compared between the two groups. Results There was no recurrence in the experimental group, 9 cases contralateral neck and 15% metastasis. Control group, 18 cases of local recurrence, 9 cases of contralateral neck metastasis, recurrence and metastasis rate of 50%. The difference was statistically significant (P <0.05). Conclusion The tongue-mouth-neck vertical continuous removal can significantly improve the oral submucosal fibrosis tongue cancer patients with clinical treatment, it is recommended.