颊黏膜和舌黏膜移植物尿道成形术后口腔供区并发症的临床研究  

Comparison study on donor site complications between buccal and lingual oral mucosal grafts harvesting for urethroplasty

作　　者：金重睿[1] 撒应龙[1] 王林[1] 舒慧泉 顾杰[1] Jin Chongrui;Sa Yinglong;Wang Lin;Shu Huiquan;Gu Jie(Department of Urology, Shanghai Jiaotong University Affiliated Sixth People′s Hospital, Shanghai Eastern Institute of Urologic Reconstruction, Shanghai 200233, Chin)

机构地区：[1]上海交通大学附属第六人民医院泌尿外科 上海东方泌尿修复重建研究所,200233

出　　处：《中华泌尿外科杂志》2018年第4期281-284,共4页Chinese Journal of Urology

摘　　要：目的分析游离颊黏膜移植物（BMG）及舌黏膜移植物（LMG）前尿道成形术后口腔供区并发症情况。方法回顾性分析2014年6月至2016年12月采用口腔黏膜游离移植物治疗的50例前尿道狭窄或尿道下裂患者的临床资料。年龄32～56岁，平均43.6岁。采用BMG者（BMG组）25例，年龄32～54岁，平均43.1岁。采用LMG者（LMG组）25例，年龄35～56岁，平均44.2岁。两组年龄差异无统计学意义（P〉0.05）。采用视觉模拟疼痛评分量表对患者术后供区疼痛情况进行评分。研究术后口腔供区常见并发症，包括进食困难、发音含糊、味觉障碍、张口紧绷感、口腔供区麻木的发生情况，比较两组患者术后3 d、2周、3个月口腔并发症的差异。结果BMG组取材长度（5.24±0.89）cm（4～7 cm），宽度（1.48±0.50） cm（1～2 cm）; LMG组取材长度（5.68±0.90 ）cm（4～7 cm），宽度（1.56±0.51） cm（1～2 cm），两组取材情况的比较差异无统计学意义（P〉0.05）。随访6～12个月，平均7.8个月。术后3 d、2周BMG组的口腔供区疼痛评分分别为（5.84±0.85）、（3.04±0.45）分，舌黏膜组分别为（7.20±0.57）、（4.16±0.62）分，两组比较差异均无统计学意义（P〉0.05）。术后3 d BMG组和LMG组患者进食困难发生率为24%（6/25）和64%（16/25），发音含糊发生率为56%（14/25）和92%（23/25），味觉障碍发生率为16%（4/25）和48%（12/25），两组比较差异均有统计学意义（P〈0.05）。术后2周BMG组的进食困难、发音含糊、味觉障碍发生率[分别为16%（4/25）、8%（2/25）、12%（3/25）]均低于LMG组[分别为32%（8/25）、40%（10/25）、40%（10/25）]，差异均有统计学意义（P〈0.05）；但BMG组口腔紧绷感的发生率高于LMG组[36%（9/25）与12%（3/25）]，差异有统计学意义（P＝0.047）。术后3个月患者供区疼痛、进食困难、味觉障碍均恢复正常，两组差异均无统�ObjectiveTo compare donor site complications of buccal or lingual mucosa grafts harvesting for substitution urethroplasty.MethodsFrom June 2014 to December 2016, a total of 50 patients who were diagnosed anterior urethral strictures or hypospadias underwent buccal or lingual mucosa grafts urethroplasty.The mean age of the patients was 43.6 years （range 32-56 years）. 25 patients used buccal mucosa grafts （BMG group）for urethroplasty with the median age of 43.1 years（range 32-54 years）; the other 25 patients received lingual mucosa grafts （LMG group） for urethroplasty, aged 44.2 years（range 35-56 years）. Patients were evaluated for postoperative oral pain morbidity using the visual analogue pain scale（0-10） as well as an questionnaire for difficulty with eating, speech impairment, dysgeusia, tightness of the mouth. The evaluations were carried out at 3 days, 2 weeks and 3 months postoperatively.ResultsIn BMG group, the length and width of the graft was （5.24±0.89） cm and （1.48±0.50）cm; the graft length was （5.68±0.90） cm and the width was （1.56±0.51）cm in LMG group.There was no difference between the two groups. The mean followup time was （7.8±1.2）months （6-12 months）. The median visual analogue pain scale scores of the BMG group 3 days, 2 weeks after surgery was 5.84±0.85, 3.04±0.45 , and the LMG group 7.20±0.57, 4.16±0.62 , respectively, with no statistical difference between two groups. The incidence of events with LMG group versus the BMG group were as follows： difficulty with eating （64% vs. 24%, P=0.004）, speech impairment （92% vs. 56%, P=0.004）and dysgeusia （48% vs. 16%, P=0.015）at day 3. The difficulty of eating, speech impairment and dysgeusia of BMG group were lower than that of the LMG group（16% vs. 32%, P=0.031; 8% vs. 40%, P=0.008; 12% vs. 40%, P=0.024）two weeks after the surgery, whereas the incidence of tightness of the mouth was higher in BMG group（36% vs. 12%, P=0.04）. After 3 months, 36% and 32% of patients treated with

关 键 词：前尿道狭窄 尿道成形 颊黏膜 舌黏膜 并发症 

分 类 号：R699[医药卫生—泌尿科学]