华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

保留颈外静脉及颈丛神经深支颈淋巴清扫术式的相关基础研究

黄欣,李龙江,温玉明,王昌美,韩波   

  1. 610041 四川大学华西口腔医院颌面外科
  • 收稿日期:2003-04-25 修回日期:2003-04-25 出版日期:2003-04-20 发布日期:2003-04-20

Basic Research on Neck Dissection with External Jugular Vein and Cervical Plexus Preserved

HUANGXin,LILongjiang,WEN Yuming,et al.   

  1. West China College ofStomatology,Sichuan University,Chengdu610041, China
  • Received:2003-04-25 Revised:2003-04-25 Online:2003-04-20 Published:2003-04-20

摘要:

目的 研究保留颈外静脉及颈丛神经深支对颈淋巴清扫术的安全性、彻底性及术后颅内和面部静脉回流的影响。方法 20例口腔鳞癌患者均采用联合根治术并保留颈神经丛深支。按保留颈外静脉与否将患者随机分为两组,每组10例。检测患者术前、术后的面部组织间质压,免疫组织化学技术染色淋巴管并计数其密度,观察记录患者的术后主观症状。结果 保留颈外静脉组术后面部组织间质压的升高及持续时间均低于不保留组。颈部不同结构淋巴管密度的均值由高至低依次为:颈内静脉、胸锁乳突肌、副神经、颈外静脉和颈丛深支。结论 保留颈外静脉及颈丛神经深支不影响颈淋巴清扫术的安全性及彻底性,并可有效改善患者术后颅内和面部的静脉回流,保存肩功能。

关键词: 颈外静脉, 颈丛神经深支, 颈淋巴清扫术

Abstract:

Objective The aim of this study was to investigate the effects of preserving external jugular vein and cervical plexus in reducing intra-cranial pressure, face swelling as well as in avoiding shoulder arm syndrome in neck dissection.Methods 20 patients with oral cancer were divided into two groups. The facial interstitial pressure was examined before and after neck dis- section and lymph tubes were stained by immunochemical techniques.Results The degree and lasting time of the increase of fa- cial interstitial pressure in groupwith external jugular vein and cervical plexus preserved was lower than that in control group. The density of lymphatic tubes around the internal jugular vein, accessory nerve and sternocleidomastoid muscleswas much higherthan that around the external jugular vein and cervical plexus.Conclusion Preserving external jugular and cervical plexus during radi- cal treatment is effective not only in reducing the intra-cranial pressure and face swelling, but also in preventing shoulder arm syn- drome.

Key words: neck dissection, external jugular vein, cervical plexus