口腔恶性肿瘤患者下颌骨切除采用不同修复方式的术后生存质量评价  

Evaluation of Postoperative Quality of Life in Patients with Oral Malignant Tumors after Mandibular Resection with Different Reconstruction Methods

作　　者：傅红[1] 秦帅华 胡爽 张帅源 秦硕 孙明磊[2] FU Hong;QIN Shuaihua;HU Shuang;ZHANG Shuaiyuan;QIN Shuo;SUN Minglei(Department of Day Surgery Center,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院日间手术中心,河南郑州450052 [2]郑州大学第一附属医院口腔颌面外科,河南郑州450052

出　　处：《口腔颌面外科杂志》2020年第5期300-304,共5页Journal of Oral and Maxillofacial Surgery

基　　金：郑州市口腔颌面外科院士工作站项目(152PYSGZ040);河南省教育厅一般项目(13A320452)。

摘　　要：目的:评价口腔恶性肿瘤患者下颌骨切除后,采用3种不同修复方式治疗术后12个月的生存质量。方法:依据下颌骨切除后的不同修复方式分为未重建组、重建板组和腓骨重建组。采用生存质量测定量表体系中的核心量表(QLQ-C30)和头颈癌生存质量问卷量表(QLQ-H&N35)完成生存质量问卷调查,比较3组患者生存质量得分的差异。结果:共纳入118例患者,平均年龄为(47.21±12.32)岁,其中未重建组40例,重建板组41例,腓骨重建组37例。重建板组及腓骨重建组较未重建组具有更好的生理功能、社会功能和整体生存质量,差异均有统计学意义(P<0.05)。在吞咽、语言、饮食、交往及感觉不适等症状方面,腓骨重建组表现出更好的功能状态和更少的症状,而未重建组生存质量最低,差异均有统计学意义(P<0.05)。结论:口腔恶性肿瘤患者下颌骨切除后,应尽可能行下颌骨修复重建术,恢复下颌骨外形和功能,以获得更高的生存质量。Objective:To assess the quality of life of patients with oral malignant tumors 12 months after mandibular resection surgery with three different mandibular reconstuction methods.Methods:Patients were divided into non-reconstruction group,titanium plate reconstruction group and fibula graft reconstruction group according to the different reconstruction methods after mandibular resection.The quality of life of the patients was evaluated by using the quality of life questionnaire core-30(QLQ-C30)and quality of life questionnaire-head and neck 35(QLQ-H&N35).The differences in the quality of life scores of the three groups of patients were compared.Results:A total of 118 patients were included in the study,with an average age of(47.21±12.32)years,including 40 patients in no-reconstruction group,41 patients in titanium plate reconstruction group,and 37 patients in fibula graft reconstruction group.The reconstruction plate group and fibula graft reconstruction group had better physiological functions,social functions,and overall quality of life than non-reconstruction group.The differences are statistically significant(P<0.05).In the symptom areas such as swallowing,language,diet,communication and discomfort,fibula graft reconstruction patients overall showed better functional status and fewer symptomatic problems,while non-reconstructed patients had the worst quality of life.The differences are statistically significant(P<0.05).Conclusions:After mandibular resection in patients with oral malignant tumors,the mandible should be reconstructed as soon as possible to restore the shape and function in order to obtain a higher quality of life.

关 键 词：口腔恶性肿瘤 下颌骨缺损 生存质量 

分 类 号：R739.8[医药卫生—肿瘤]