摘要:目的:探討超聲與核素顯像在評價干燥綜合征(SS)腮腺受累情況中的價值和作用。方法:對65例SS病人分別進行超聲和核素顯像檢查。結果:超聲判為腮腺功能0級、I級、ⅡⅢ級、Ⅳ級的能力與核素顯像判為正常(χ2=0.075,Pgt;0.05)、輕度(χ2=0.12,Pgt;0.05)、中度(χ2=0.27,Pgt;0.05)、重度(χ2=0.097,Pgt;0.05)受損的能力一致,差異無統計學意義;核素發現單純攝取功能受損的超聲多表現為不均勻型、單純排泌功能受損的超聲多表現為結節型、攝取和排泌功能均受損的超聲多表現為纖維化型。結論:超聲檢查可作為SS患者腮腺受累情況評價的良好手段。Abstract: Objective: To quantitatively evaluate ultrasonography and radionuclide imaging in thediagnosis of parotid gland involvement in Sjogren syndrome (SS). Methods: Ultrasonography and radionuclide imaging were conducted on 65 cases with primary Sjogren syndrome. Results: There was no significant difference statistically between the ultrasonographic appearance of the parotid gland and radionuclide imaging (P gt;0. 05). Conclusion: As for diagnosis and evaluating the parotid gland of Sjogren syndrome, ultrasonography may be the useful choice.
Objective To investigate the effectiveness of free peroneal artery chimeric perforator flap in repairing the defect after advanced local lesions resection in parotid gland carcinoma (PGC). Methods Between June 2010 and June 2020, 32 patients with advanced local lesions of PGC were treated with extended radical resection. After that, 17 patients were repaired with the free peroneal artery chimeric perforator flaps (trial group) and another 15 patients were repaired with the pedicled pectoralis major myocutaneous flaps (control group). There was no significant difference in gender, age, disease type, histopathological classification, clinical stage, and pathological stage between groups (P>0.05). The size of skin flap in trial group ranged from 7 cm×6 cm to 12 cm×8 cm and the size of soleus muscle flap ranged from 5 cm×3 cm to 6 cm×4 cm. The donor sites were repaired with skin grafting. The size of the pedicled pectoralis major myocutaneous flaps in control group ranged from 9 cm×6 cm to 14 cm×7 cm. The donor sites were sutured directly. The operation time, survival rate of flap, and postoperative survival of patients were recorded and compared between groups. At 1 year after operation, the University of Washington quality of life (UW-QOL) questionnaire was used to evaluate the quality of life of patients in the two groups, including appearance, shoulder movement, sociability, masticatory function, speech function, and mood. Results The operations completed successfully. The operation time was (6.19±0.72) hours in trial group and (6.41±0.71) hours in control group, showing no significant difference between groups (t=–0.863, P=0.395). The survival rate of flap in trial group was 94.1% (16/17); and 1 patient suffered from vascular crisis after operation and was replaced with the pedicled pectoralis major myocutaneous flap. The survival rate of flap in control group was 100%. All grafts survived and the incisions healed by first intention in the two groups. All patients were followed up. The follow-up time was 6-60 months (median, 60 months) in trial group and 7-60 months (median, 60 months) in control group. Cumulative survival rates of patients at 1, 3, and 5 years after operation were 94.1%, 64.7%, and 58.8% in trial group, respectively; 86.7%, 66.7%, and 53.3% in control group, respectively. There was no significant difference in the cumulative survival rate between groups (χ2=0.090, P=0.762). According to the UW-QOL questionnaire at 1 year after operation, the scores of appearance, shoulder movement, sociability, and mood in trial group were significantly higher than those in control group (P<0.05); and there was no significant difference in masticatory function and speech function scores between groups (P>0.05). Conclusion The peroneal artery perforator has an invariable anatomical relationship. Each perforator emits the muscular branch that nourishes the soleus muscle. Therefore, personalized free peroneal artery chimeric perforator flap can be designed according to the tissue defect, and used to repair the defect after advanced local lesions resection in PGC.