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目的 :对传统颈淋巴清扫术手术入路进行分析 ,以选择最佳手术切口。方法 :收集颈淋巴清扫术 3 6例 ,其中矩形切口 18例 ,T形切口 15例 ,平行切口 3例。观察三种手术入路术后皮肤坏死情况 ,将皮瓣坏死分 3度比较分析。并观察三种手术入路视野暴露情况、操作难易程度及操作时间。结果 :矩形切口出现皮肤坏死率与T形切口、平行切口皮肤坏死率有显著性的差异 (P <0 .0 0 1)。矩形切口和T形切口均能很好地暴露术野 ;平行切口视野暴露较差 ,操作难度大 ,手术时间长。结论 :颈淋巴清扫术中矩形切口手术入路不是一种十分理想的手术入路 ,为了避免皮肤坏死并发症的产生 ,应当改良此切口入路或选用T形切口和其他切口入路。
Objective: To analyze the surgical approach of traditional neck dissection in order to choose the best surgical incision. Methods: Totally 36 cases of cervical lymphadenectomy were collected, including 18 cases of rectangular incision, 15 cases of T-shaped incision and 3 cases of parallel incision. Observation of three kinds of surgical approach postoperative skin necrosis, the flap necrosis divided by 3 degrees comparative analysis. And to observe the three surgical approach visual field exposure, ease of operation and operation time. Results: There was a significant difference in the rate of skin necrosis between rectangular incision and T-incision and parallel incision (P <0.01). Rectangular incision and T incision can well expose the surgical field; parallel incision field of vision exposure is poor, the operation is difficult, long operation time. CONCLUSION: Rectangular incision approach in neck dissection is not a very ideal surgical approach. To avoid the occurrence of skin necrosis complications, this incision should be improved or T incision and other incisions should be selected.