羊书勇，郑维银，李晨军，李　浩，鄢兰元，李　焰，吴　坡，蒋　佶



颈淋巴清扫术后不同负压引流管放置方式的对比试验

羊书勇，郑维银，李晨军，李浩，鄢兰元，李焰，吴坡，蒋佶

目的通过临床对比试验，比较传统放置负压引流管的方法与新的放置方法之间有无效果方面的差异。方法选择笔者所在科室中接受颈淋巴清扫和皮瓣修复血管吻合的口腔颌面部肿瘤患者50例，随机分为实验组和对照组。对照组采用传统方法放置负压引流管，引流管避开血管放置；实验组以可即邦医用胶原蛋白海绵覆盖保护血管，引流管在可即邦医用胶原蛋白海绵表面交叉放置，无需对血管刻意避让。观察比较两组术后伤口负压引流量、愈合情况以及皮瓣血运情况。结果术后两组皮瓣均血运正常，负压引流量无明显差异。结论新的负压引流管放置方式简单易行，对颈部大血管和游离皮瓣血管吻合口无明显不利影响，伤口愈合无明显差异。

颈淋巴清扫术;负压;引流管;放置方式

[Abstract]Objective To make comparison of differences in effects between conventional placement method of negative pressure drainage tube and new method through clinical comparative trial.Methods 50 patients with oral and maxillofacial tumor who accepted neck dissection and flap vascular anastomosiswere selected and random ly divided into experimental and control groups. The control group received the traditional placementmethod of negative pressure drainage tubes which avoided blood vessels.The experiment group's vessels were covered and protected by collagen sponge,and the drainage tubes were placed without deliberate avoidance of vessels.Observation and analysisweremade in the postoperative negative pressure drainage volume,healing conditions, and the flap blood supply situation between the two groups.Results Blood supply to the flaps was normal in both groups after the operation,and there was no significant difference in the negative pressure drainage.Conclusion The new placement method of negative pressure drainage tube is simp le and brings no significant adverse effects to large vessels and neck free flap vascular anastomosis.And there is no significant difference in the wound healing.

[Keywords]neck dissection;negative pressure;drainage tube;placement

口腔颌面部的恶性肿瘤采用手术方法治疗时，除了进行颈淋巴清扫和原发病灶扩大切除外，为了修复原发病灶切除后形成的缺损，常常还需要进行游离皮瓣的转移修复。游离皮瓣的动静脉经常吻合于颈部的动静脉，如颌外动脉和面总静脉上。以上手术方式导致颈部众多重要大血管暴露，所以，在放置负压引流管时，应同时考虑引流的有效性和对重要大血管及皮瓣血管吻合口的保护。……