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颈清扫术中改善术后肩功能方法的初步探讨 被引量:9

A PRELIMINARY STUDY ON TWO MODIFIED PROCEDURES OF RADICAL NECK DISSECTION FOR IMPROVING SHOULDER FUNCTION
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摘要 目的 观察并论证两种改进颈清扫术式的优越性及改善术后斜方肌功能的效果。方法  2 4例需行颈清扫术的患者 ,每组 12例 ,分别在颈清扫术中保留颈丛斜方肌分支 (MRND1)或采用颈丛肩胛提肌支与副神经移位吻合 (MRND2 )。结果 手术 6月后 ,MRND1和 MRND2均可获得较大程度的斜方肌功能恢复 ,MRND1和MRND2的上肢平均最大外展角度分别为 96 .6 7°和 98.13°,5 0 %的患者可以外展上臂超过 90°。结论  MRND1和MRND2均可较大程度地保存和恢复术后斜方肌的功能 ,改善传统颈清扫术 (RND)后的肩综合征 ,既不违反根治肿瘤的原则 ,同时具有简便、无联带运动、利于斜方肌神经再生、功能恢复等优点。临床上可以用来代替传统 RND。 Objective The advantages and effects on shoulder function of two functional modifications of RND proposed by this paper have been evaluated. Methods preserving branches of C3, C4 to trapezius muscle (MRND1) and transposition anastomosis of the branches of cervical plexus to levator scapulae with the accessory nerve(MRND2) during neck dissection were performed in twenty four cases neck dissection, each modality contains 12 cases. Results A significant functional rehabilitation of trapezius muscle can be achieved by both modified operative styles 6 months postoperation, the average maximal angle of abducting the arm is 96.67° and 98.13° in MRND1 and MRND2 respectively, 50% patients can abduct the arm beyond 90°. Conclusion The postoperative shoulder syndrome can be improved to a certain extent by both MRND1 and MRND2. These two modifications without compromiging the oncological eradication have many advantages in functional rehabilitation of the trapezius muscle, which suggests that traditional RND might be replaced by these two modifications to improve patients quality of life.
出处 《口腔颌面外科杂志》 CAS 2001年第1期4-7,共4页 Journal of Oral and Maxillofacial Surgery
关键词 改良根治性颈清扫术 颈丛 斜方肌 副神经 肩功能 Modified radical neck dissection(MRND) Cervical plexus Trapezius muscle Accessory nerve Shoulder syndrome
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  • 1吴煜农 邱蔚六 等.颈清扫术斜方肌功能呆存及恢复的研究.上海第二医科大学博士学位论文[M].,1998.26. 被引量:1

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