舌骨下肌肌皮瓣和桡侧前臂皮瓣修复半舌缺损术后患者生活质量的比较  

Comparison of the quality of life between patients underwent reconstruction after hemiglossectomy using infrahyoid myocutaneous flap and radial forearm flap

作　　者：徐敏[1] 杨熙鸿[1] 郭海鹏[1] 陈伟正[1] 林建英[1] 彭汉伟[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院头颈外科,广东汕头515031

出　　处：《中国耳鼻咽喉头颈外科》2016年第3期131-134,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的比较桡侧前臂皮瓣（radial forearm flap,RFF）和舌骨下肌肌皮瓣（infrahyoid myocutaneous f lap,IHMCF）成功修复半舌缺损术后患者的生活质量,探讨半舌缺损修复方法的选择。方法采用非随机对照研究。2005年6月-2012年6月我科共行标准半舌切除＋半舌缺损修复术且皮瓣完全存活病例24例,均为舌侧缘鳞状细胞癌,未累及舌根,其中T2 19例,T3 5例,根据供区不同分为RFF组（n=10）和IHMCF组（n=14）;对比两组病例术后1年患者生活质量,采用EORTC-QLQ30及FACT-H＆N35量表进行评价。结果 EORTC-QLQ30量表各领域得分的差异无统计学意义,FACT-H＆N35量表中进食（P=0.005）、语言（P=0.008）、牙齿（P=0.014）、咳嗽（P=0.009）4个领域I H M C F组得分高于R F F组。结论 RFF和IHMCF修复半舌缺损术后总体生活质量相近,而口腔功能则以IHMCF组患者为优;在保证手术成功率的前提下,IHMCF在半舌缺损修复中是RFF良好的替代方法。OBJECTIVE This study was designed to compare the quality of life between patients who underwent a tongue reconstruction with radial forearm flap（RFF） and infrahyoid myocutaneous f lap（IHMCF） after hemiglossectomy for their tongue cancers,and to figure out an optimal reconstructive method for the defects resulted from hemiglossectomy.METHODS A non-randomized case-control study was performed on 24 patients with tongue squamous cell carcinoma who underwent a standard hemiglossectomy combined with perfectly tongue reconstruction from June 2005 to June 2012.All of the cases were without tongue base invasion.Of the 24 cases,19 had T2 disease,5 had T3 disease,and they were divided into RFF group（n=10） and IHMCF group（n=14）.The quality of life were evaluated one year after operation using EORTCQLQ30 and FACT-HN35 and compared between the two groups.RESULTS The scores were comparable between the two group with regard to all domains of EORTC-QLQ30,with all P values〉0.05.The scores of swallowing（P=0.005）,speech（P=0.008）,teeth（P=0.014）,and cough（P =0.009） domains were significantly higher in IHMCF group than in RFF group,with P value of 0.005,0.008,0.014 and 0.009 respectively,while the other domains of FACT-HN35 were comparable between the two groups,with all P values〉0.05.CONCLUSION Overall quality of life was similar in the two groups.Oral function domains were better in IHMCF group than in RFF group.When guarantee of flap survival is available,IHMCF could be used as a good alternative flap to RFF in tongue reconstruction after hemiglossectomy.

关 键 词：舌肿瘤 修复外科手术 生活质量 评价研究 桡侧前臂皮瓣 舌骨下肌肌皮瓣 口腔功能 

分 类 号：R739.86[医药卫生—肿瘤]