股前外侧皮瓣修复舌根癌的生活质量调查  

Assessment of the quality of life of tongue base cancer patients after reconstruction with anterolaterai thigh perforator flap

作　　者：高宁[1] 付坤[1] 何巍[1] Gao Ning, Fu Kun, He Wei(Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,450052

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第3期214-218,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析应用股前外侧皮瓣修复舌根癌术后缺损患者的生活质量，为临床治疗提供参考。方法以2011年1月至2016年8月郑州大学第一附属医院口腔颌面外科治疗的77例舌根癌患者为研究对象，应用口腔健康影响程度量表（the 14－item Oral Health Impact Profile questionnaires，OHIP－14）和欧洲肿瘤研制组织制定的头颈部生存质量量表（European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module, EORTC－QLQ－H＆N35）对患者术前、术后3个月、术后12个月的生活质量进行调查和评估。使用单因素方差分析对每组3个时间点的OHIP－14和EORTC－QLQ－H＆N35分值行独立样本t检验。结果OHIP－14调查显示：生理性疼痛在术后3个月时即可得到明显的缓解，术后12个月和术后3个月得分相比差异无统计学意义[（40.6±10.3）分比（39.2±10.6）分，t＝－0.812，P＝0.948]；心理不适和心理障碍在术后3个月时得分最高，术后12个月时依然无法恢复到术前水平；功能限制在术后12个月得分虽然比术后3个月的得分低，但是依然无法恢复至术前水平。EORTC－QLQ－H＆N35调查显示：吞咽、语言和饮食在术后3个月时得分较高，在术后12个月时改善明显；牙齿和张口度在术前和术后得分均较低，且差异无统计学意义。结论采用股前外侧皮瓣修复舌根癌，能够恢复患者外形、语言和咀嚼功能的基本需求，提高患者的生活质量。ObjectiveTo evaluate the quality of life （QOL） of patients who underwent resection of tongue base cancer and reconstruction by anterolateral thigh perforator free flap（ALTFF）.MethodsA total of 77 patients with tongue cancer who underwent glossectomy and reconstruction by ALTFF were retrospectively analyzed in this work. At intervals of 3-month before operation, as well as both 3-month and 12-month post-operation, the QOL of these patients was assessed by using the 14-item Oral Health Impact Profile questionnaires（OHIP-14） and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module（EORTC-QLQ-H＆N35）.ResultsThe OHIP-14 questionnaire showed the physiological pain can be significantly alleviated at 3 months postoperatively. The highest score were psychological discomfort and psychological disorders at 3 months postoperatively. Functional limitations cannot be restored to preoperative level at 12 months postoperatively, although lower than that in 3 months postoperatively（40.6±10.3 vs 39.2±10.6, t=-0.812, P=0.948）. The EORTC-QLQ-H ＆ N35 survey showed that swallowing, language and diet were higher at 3 months postoperatively, and improved significantly at 12 months postoperatively. Teeth and mouth opening was lower before and after surgery, and no significant difference was observed.ConclusionThe use of ALTFF to repair tongue base cancer, can restore the patient′s appearance, language and chewing function of the basic needs and improve the quality of life of patients.

关 键 词：舌肿瘤 外科皮瓣 修复外科手术 生活质量 

分 类 号：R739.86[医药卫生—肿瘤]