颏下岛状皮瓣与前臂皮瓣修复口腔鳞癌术后缺损的比较  

Comparison of Outcomes of Submental Island Pedicled Flap and Radial Forearm Free Flap for Reconstruction of Oral Defects following OSCC Ablation

作　　者：刘汉前[1] 俞辉明[1] 毛弛[2] 

机构地区：[1]南京医科大学附属淮安第一医院口腔科,江苏淮安223300 [2]北京大学口腔医学院

出　　处：《口腔医学研究》2014年第6期569-572,共4页Journal of Oral Science Research

基　　金：淮安市科技支撑计划(编号:HAS2013015)

摘　　要：目的：比较颏下岛状皮瓣与游离前臂皮瓣修复口腔鳞癌术后缺损的结果。方法：2009年5月~2011年8月,69例口腔鳞癌术后缺损采用颏下岛状皮瓣或游离前臂皮瓣修复,比较2种修复方法的皮瓣大小、手术时间、住院时间、并发症、口腔功能恢复及复发情况。结果：69例患者中,采用颏下岛状皮瓣修复32例,游离前臂皮瓣修复37例。颏下岛状皮瓣组与游离前臂皮瓣组在平均皮瓣大小（32.78cm2 VS 48.27cm2）、平均手术时间（351min VS 508min）、平均住院日（13.06dVS 17.48d）等均有统计学差异（P〈0.001）;两组患者总的并发症发生相似,但颏下岛状皮瓣组发生颌下区积液的比例较高（P〈0.05）;两组患者在术后口腔功能恢复及肿瘤复发方面无差异。结论：颏下岛状皮瓣修复可明显缩短手术时间及患者住院时间,可作为口腔鳞癌术后中小型缺损修复的首选。Objective： To compare the results of submental island pedicled flap （SIPF） against radial forearm free flap （RFFF） for reconstruction of the soft tissue defects following oral squamous cell carcinoma （OSCC） ablation. Methods.. From May 2009 to August 2011,69 consecutive patients with OSCC were underwent resection of the oral lesion ,and the soft tissue defects were immediately reconstructed with SIPF or RFFF . The flap size ,duration of operation hospital stay, complications, oral function recovering and tumor recurrence outcomes were compared between two reconstructive methods. Results： The study included 69 patients,32 with SIPF reconstruction and 37 with RFFF reconstruction. Age, sex, tumor location, TNM stage, pathologic differentiation and type of neck dissection were similar for both groups. Mean flap size （32.78 cm2 VS 48.27 cm2） ,mean operation times（351 minutes VS 508 minutes）, and mean hospitalizations（13. 06 days VS 17. 48 days） were observed significantly between SIPF and RFFF. Total complications in recipient site or donor site were more prevalent with RFFF reconstruction than SIPF reconstruction, but no significant. However, there was more percentage to take place a hydrops in the mandibular region with SIPF reconstruction than RFFF. Oral functional outcomes and disease recurrence in the following--up were similar for both groups. Conclusion： Reconstruction of oral defects with SIPF can shorten significantly operative time and hospitalization, The SIPF may be a preferable option for reconstruction of middle--small oral cavity defects following OSCC ablation.

关 键 词：颏下皮瓣 桡侧游离前臂皮瓣 修复 口腔缺损 鳞状细胞癌 

分 类 号：R739.85[医药卫生—肿瘤]