改良颏下动脉穿支皮瓣修复口腔颌面部恶性肿瘤术后软组织缺损的应用研究  

Application of modified submental artery perforator flap in repairing soft tissue defects after oral and maxillofacial malignant tumor surgery

作　　者：王春 赵曦[1] 谭雪梅 雷晓旭 WANG Chun;ZHAO Xi;TAN Xue-mei;LEI Xiao-xu(Department of Stomatology,the People’s Hospital of Deyang City,Sichuan Deyang 618000,China)

机构地区：[1]德阳市人民医院口腔科,四川德阳618000

出　　处：《临床口腔医学杂志》2020年第7期428-431,共4页Journal of Clinical Stomatology

基　　金：四川省德阳市科技局项目(2018szs074)。

摘　　要：目的:研究改良颏下动脉穿支皮瓣(submental artery perforator flap,SMAPF)修复口腔颌面部恶性肿瘤术后软组织缺损的效果。方法:回顾性分析口腔颌外科收治的口腔癌患者60例,根据手术方式不同将患者分为改良组和常规组各30例,改良组给予改良SMAPF进行术后软组织修复,常规组给予颏下动脉岛状皮瓣(submental island flap,SMIF)进行修复,比较两组皮瓣存活情况、皮瓣修复情况、皮瓣修复相关时间以及皮瓣修复效果。结果:两组皮瓣存活率均为100.00%;改良组皮瓣大小明显小于常规组(P<0.05),血管蒂长度与常规组比较,无明显差异(P>0.05);改良组制瓣时间明显长于常规组(min),修复手术时间、术后住院时间明显短于常规组(P<0.05)。术后6个月,两组患者创面色泽评分无明显差异(P>0.05),改良组创面美观度、功能评分明显高于常规组(P<0.05)。结论:改良SMAPF修复口腔颌面部恶性肿瘤术后软组织缺损效果良好,且更加适用于中小型软组织缺损修复,是一种理想的皮瓣修复方式。Objective:To study the effects of modified submental artery perforator flap(SMAPF)on soft tissue defects after oral and maxillofacial malignant tumor surgery.Methods:Retrospective analysis of 60 patients with oral cancer treated in the Department of Oral and Maxillofacial Surgery were selected as research subjects.They were divided the patients into modified group and conventional group according to different surgical methods,with 30 cases in each group.Modified group was given modified SMAPF for postoperative soft tissue repair,and conventional group was given submental artery island flap(SMIF)repair.The flap survival,flap repair status,flap repair related time and effects were compared between the two groups.Results:The flap survival rates in the two groups both were 100.00%.The flap size in modified group was significantly smaller than that in conventional group(P<0.05),and the length of vascular pedicle was not significantly different from that in conventional group(P>0.05).The flap making time in modified group was longer than that in conventional group,and the repair operation time and postoperative hospital stay were significantly shorter than those in conventional group(P<0.05).There was no significant difference in wound color score between the two groups(P>0.05),and the scores of wound aesthetic degree and function in modified group were significantly higher than those in conventional group(P<0.05).Conclusion:Modified SMAPF has a good effect in repairing soft tissue defects after oral and maxillofacial malignant tumor surgery,and it is more suitable for small and medium-sized soft tissue defects,and it is an ideal skin flap repair method.

关 键 词：改良 颏下动脉穿支皮瓣 口腔肿瘤 软组织缺损 

分 类 号：R782.2[医药卫生—口腔医学] R739.8[医药卫生—临床医学]