口腔医学研究

口腔医学研究 ›› 2023, Vol. 39 ›› Issue (4): 322-327.DOI: 10.13701/j.cnki.kqyxyj.2023.04.007

• 口腔肿瘤学研究 • 上一篇    下一篇

计算机导航技术在累及上颌骨的晚期恶性肿瘤根治性手术中的应用探讨

吴朱昊, 张兴伟, 孙亚威, 李子慧, 陈欣, 蒲玉梅, 董迎春, 孙国文*   

  1. 南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科 江苏 南京 210008
  • 收稿日期:2022-10-31 出版日期:2023-04-28 发布日期:2023-04-19
  • 通讯作者: *孙国文,E-mail:guowensun@nju.edu.cn
  • 作者简介:吴朱昊(1996~ ),男,江苏盐城人,硕士在读,研究方向:口腔颌面外科。

Application of Computer Navigation Technology in Radical Surgery for Advanced Malignant Tumors Involving Maxilla

WU Zhuhao, ZHANG Xingwei, SUN Yawei, LI Zihui, CHEN Xin, PU Yumei, DONG Yingchun, SUN Guowen*   

  1. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
  • Received:2022-10-31 Online:2023-04-28 Published:2023-04-19

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摘要： 目的: 探讨计算机导航技术在累及上颌骨的晚期恶性肿瘤根治性手术中的应用。方法: 选择南京大学医学院附属口腔医院(南京市口腔医院)口腔颌面外科一病区2015年1月~2022年1月就诊的累及上颌骨的晚期恶性肿瘤患者59例分为实验组和对照组,研究计算机导航技术在术中的应用价值。结果: 在计算机导航技术的辅助下,59例患者均成功完成手术,病灶切除完整,切除范围均邻近颅底,达翼板根部,保障了足够的深部手术安全切缘,颅底周围重要的解剖结构未受到损伤。实验组平均手术时间为(6.29±2.76) h,平均术中出血量为(803.67±321.18) mL,切缘阳性率为(3.03±1.33)%。对照组平均手术时间为(7.49±1.50) h,平均术中出血量为(931.03±337.44) mL,切缘阳性率为(8.17±1.90)%。截至2022年9月,实验组30例患者最长生存时间为88个月,最短生存时间为5个月,平均生存时间为(36.42±22.35)个月。对照组29例患者最长生存时间为87个月,最短生存时间为3个月,平均生存时间为(31.49±24.08)个月。实验组中1例患者需鼻饲进食,对照组中有3例患者需鼻饲进食。结论: 计算机导航技术有助于外科医生更好地保护颅底重要解剖结构,并能更好地控制上颌骨后份深部的手术安全切缘,增加手术安全性,在确定累及上颌骨的晚期恶性肿瘤患者的手术彻底性方面具有一定意义。

关键词: 计算机导航技术, 晚期上颌骨肿瘤, 手术安全切缘

Abstract: Objective: To explore the application of computer navigation technology in the radical surgery of advanced malignant tumors involving the maxilla. Methods: Fifty-nine patients with advanced malignant tumors involving the maxilla who visited the First Ward of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital from January 2015 to January 2022 were selected and divided into the experimental group and the control group. The application value of computer navigation technology in surgery was analyzed retrospectively. Results: With the help of computer navigation technology, 59 patients successfully completed the surgery. The lesions were completely removed, and the removal scope was close to the skull base and reached the root of the wing plate, ensuring sufficient safe margins for deep surgery. In the experimental group, the average operation time was (6.29±2.76) hours, the average intraoperative bleeding volume was (803.67±321.18) mL, and the positive rate of the incision margin was (3.03±1.33)%. The average operation time of the control group was (7.49±1.50) hours, the average intraoperative bleeding volume was (931.03±337.44) mL, and the positive rate of the incision margin was (8.17±1.90)%. As of September 2022, the maximum survival time of 30 patients in the experimental group was 88 months, the minimum survival time was 5 months, and the average survival time was (36.42±22.35) months. The longest survival time of 29 patients in the control group was 87 months, the shortest survival time was 3 months, and the average survival time was (31.49±24.08) months. One patient in the experimental group needed nasal feeding, and three patients in the control group needed nasal feeding. Conclusion: The computer navigation technology can help surgeons better protect the important anatomical structures of the skull base, better control the safe surgical margin of the posterior deep part of the maxilla, and increase the surgical safety. It has a certain significance in determining the surgical thoroughness of patients with advanced malignant tumors involving the maxilla.

Key words: computer navigation technology, advanced maxillary tumors, safe surgical margin