血管化游离腓骨肌皮瓣修复下颌骨节段性缺损40例效果评价  

Clinical application of vascularized free fibular bone flap for repairing segmental mandibular defects in 40 cases

作　　者：吴源[1] 高鹏[1] 李海涛[1] WU Yuan;GAO Peng;LI Hai-tao(Department of Stomatology,Qinghai Red Cross Hospital,Xining 810000,Qinghai Province,China)

机构地区：[1]青海红十字医院口腔科,青海西宁810000

出　　处：《上海口腔医学》2021年第1期93-96,共4页Shanghai Journal of Stomatology

摘　　要：目的:探讨血管化游离腓骨肌皮瓣修复下颌骨节段性缺损的效果。方法:选择2015年6月—2018年5月在青海红十字医院接受治疗的下颌骨节段性缺损患者80例。采用随机数字表法将患者分为2组,每组各40例。2组患者均由同一组具有5年以上临床经验的医护人员进行手术。对照组行非血管化髂骨移植修复,实验组行血管化游离腓骨肌皮瓣修复。比较2组患者移植效果、疼痛、生命质量、负性情绪及并发症。采用SPSS 22.0软件包对数据进行统计学分析。结果:2组患者近中牙龈乳头、远中牙龈乳头、唇侧龈缘弧度、唇侧龈缘高度得分差异无统计学意义(P>0.05),实验组根表面牙龈质地及颜色得分、总分均显著高于对照组(P<0.05)。术后2组患者VAS、焦虑、抑郁评分显著下降,但实验组下降幅度更大(P<0.05)。2组患者躯体功能、心理及社会功能、生命质量均显著升高,但实验组升高幅度更大(P<0.05)。对照组发生并发症3例(7.5%),肺炎、感染及伤口复发各1例,实验组2例(5%)出现并发症,伤口复发及肺炎各1例,2组比较差异无统计学意义(P>0.05)。结论:血管化游离腓骨肌皮瓣修复下颌骨节段性缺损可显著提高修复效果、缓解疼痛及负性情绪,提高患者生活质量且不增加并发症发生率。PURPOSE:To investigate the effect of vascularized free fibular flap in repairing segmental mandibular defects.METHODS:Eighty patients with segmental mandibular defects treated in our hospital from June 2015 to May2018 were enrolled.Both groups of patients were operated by the same group of medical staff with more than 5 years of clinical experience.Patients were divided into 2 groups using a random number table method,40 in each group.Patients in the control group underwent non-vascularized iliac bone graft while patients in the experimental,group underwent vascularized free fibular bone flap repair.The graft survival,pain,quality of life,negative emotions and complications were compared between the two groups using SPSS 22.0 software package.RESULTS:There was no significant difference in the scores of the proximal gingival papilla,distal gingival papilla,labial margin and labial margin(P>0.05).The gingival texture,color score and total score of the root surface of the experimental group were significantly higher than the control group(P<0.05).The scores of VAS,anxiety and depression in both groups were significantly decreased after operation,but the decrease in the experimental group was greater(P<0.05).Physical function,psychological and social function,life quality of the two groups were significantly increased,but the increase of the experimental group was greater(P<0.05).Three cases(7.5%)developed complications in the control group,including 1 case of pneumonia,1 case of infection and 1 case of wound recurrence.Two cases(5%)in the experimental group developed of complications,including 1 case of wound recurrence and 1 case of pneumonia,the difference was not statistically significant(P>0.05).CONCLUSIONS:Repair of mandibular segmental defect with vascularized free fibular bone flap can significantly improve the overall effect,relieve pain and negative emotion,improve quality of life of patients and decrease incidence of complications.

关 键 词：血管化游离腓骨瓣 下颌骨 节段性缺损 

分 类 号：R783.5[医药卫生—口腔医学]