SIMF和FSG修复老年患者颊癌术后缺损的对照研究  

Control study on submental island flap and free skin graft in buccal reconstruction of buccal defects after resection of buccal cancers by in aged patients

作　　者：梁刚[1] 郑田[2] 季平[2] 何平[1] 赵洪伟[2,3] 

机构地区：[1]四川省达州市中心医院口腔科,63500 [2]重庆医科大学附属口腔医院口腔外科,401147 [3]重庆市口腔疾病与生物医学重点实验室,401147

出　　处：《重庆医学》2014年第29期3918-3920,共3页Chongqing medicine

基　　金：重庆市卫生局科研基金项目(07-2-178)

摘　　要：目的探讨颏下岛状皮瓣(SIMF)和游离皮片(FSG)在修复老年患者颊癌术后颊部缺损的临床应用效果。方法 44例老年颊癌患者行颊癌根治术和颈淋巴清扫术后同期分别应用颏下SIMF(n=19)和FSG(n=25)修复颊部缺损。比较两组患者术后颊部外形恢复程度、开口受限程度、语音功能、咀嚼功能等情况。结果 SIMF组1例出现皮岛坏死,清创后发现肌瓣血运良好,其余全部成活,皮瓣移植成功率94.7%(18/19),供区直接拉拢缝合FSG组的移植成功率为100.0%(25/25);SIMF组所有病例术后12个月随访,颊部外形恢复程度、张口受限程度、语音功能、咀嚼功能均优于FSG组(P<0.05)。FSG组有1例术后5月出现原发灶复发。两组间在复发转移情况方面差异无统计学意义(P>0.05)。结论颏下SIMF适合老年患者颊癌切除术后组织缺损的修复,提高了患者术后生存质量,具有较好的临床应用前景。Objective To observe and evaluate the clinical effect of submental island myocutaneous flap（SIMF） and free skin graft（FSG） for the reconstruction of buccal defect resulted from the buccal carcinomas .Methods Forty-four aged aging patients di-agnosed with the buccal carcinomas were operated by the total dissection of primary tumor and selective neck dissection and recon-structed simultaneously with SIMF（19 cases） and FSG（25 cases） .The degree of postoperative cheek shape ,limitation of mouth o-pening ,speech sound ,and function of chewing were observed and analyzed .Results Eighteen SIMFs were completely survived .The residual muscle flap had a good blood supply after the debridement of skin island in one case ,the successful rate of flaps was 94 .7%（18/19） while 100% （25/25） .The donor site of SIMF was sutured directly .Follow-up was taken in 12 months for all patients .In SIMF group ,the degree of postoperative cheek shape ,limitation of mouth opening ,speech sound ,and function of chewing were bet-ter than those of FSG group in FSG group（P〈0 .05） .There was no significant difference between 2 groups in the field of recur-rence and metastasis although the recurrence adjacent to the primary tumor had happened in FSG group in 5 months after operation （P〉0 .05） .Conclusion The submental island flap is an excellent choice for the reconstruction of cheek defects in aging patients af-ter resection of buccal carcinoma .With acceptable cosmetic ,functional results and reasonable oncological saftety ,SIMF has a prom-ising prospect in head and neck surgery .

关 键 词：面部肿瘤 外科皮瓣 缺损 游离皮片 

分 类 号：R739.8[医药卫生—肿瘤]