颏下岛状皮瓣与游离股前外侧皮瓣在舌癌术后舌缺损修复的对比分析  

Repair of tongue defect with submental artery island flap and free anterolateral thigh flap after resection of tongue cancer:A comparative analysis

作　　者：李新强 朱秋俞 朱丹丹 吴爽[1] 李文鹿[1] LI Xinqiang;ZHU Qiuyu;ZHU Dandan;WU Shuang;LI Wenlu(Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,郑州450000

出　　处：《中华显微外科杂志》2021年第2期161-165,共5页Chinese Journal of Microsurgery

摘　　要：目的:比较分析颏下岛状皮瓣(SAIF)和游离股前外侧皮瓣(ALTF)在舌癌根治术后舌缺损修复中的临床效果及优、缺点。方法:2016年1月-2018年12月,共收治舌癌根治后舌缺损修复40例,男28例,女12例,平均年龄51岁。18例用SAIF进行舌修复重建,22例用ALTF修复重建。术后均门诊随访,对手术的临床资料进行分析,对二种修复方式术后吞咽功能、语言功能及舌体柔软度以及手术时间、出血量等进行对比和统计学分析, P<0.05为差异有统计学意义。 结果:本组18例SAIF和22例ALTF术后全部成活,其中1例ALTF术后出现静脉血管危象,清除吻合部位血栓后再次手术皮瓣成活。术后随访12~48个月,二组患者术后舌功能恢复情况为语言功能差异无统计学意义(SAIF和ALTF组分别为13例、15例, P=0.206),但是吞咽功能障碍SAIF组明显高于ALTF组(SAIF和ALTF组分别为15例、7例, P=0.014),而且SAIF组手术平均时间(3.5 h)明显低于ALTF组(6.8 h),差异均有统计学意义( P<0.05)。 结论:SAIF和ALTF均是舌癌术后缺损修复重建的理想方法:SAIF手术操作简单,制取时间短;ALTF可提供足够的组织量,术后可隐匿瘢痕,减少供区并发症,有利于吞咽及语言功能的恢复。Objective To compare and analyse the clinical outcome,advantages and disadvantages of submental artery island flap(SAIF)and free anterolateral thigh flap(ALTF)in the repair and reconstruction of tongue after radical surgery of tongue cancer.Methods From January,2016 to December,2018,a total of 40 patients received tongue repair and reconstruction with either SAIF or ALTF after radical resection of tongue cancer.There were 28 males and 12 females,with an average age of 51 years old.Eighteen patients received tongue repair and reconstruction with SAIF and 22 with ALTF.Postoperative follow-up were carried out and the clinical data were collected.Swallowing,speech and softness of the tongue between the 2 repair methods were compared and statistically analysed.P<0.05 indicated a significant statistical difference between 2 groups.Results All flaps survived.One ALTF had a venous vascular crisis.The flap survived after the removal of thrombus at the anastomotic site.Functional recovery of tongue was analysed after the follow-up of 12-48 months.It was found that there was no significant difference in speech function between the 2 groups(SAIF vs ALTF:13 vs 15,P=0.206).The swallowing dysfunction in SAIF group was significantly higher than that of the ALTF group(SAIF vs ALTF:15 vs 7,P=0.014).Moreover,the average time of surgery in SAIF group(3.5 h)was significantly less than that of the ALTF group(6.8 h),which had statistically significance(P<0.05).Conclusion The SAIF and ALTF are ideal flaps for repairing the tongue defect caused by tongue cancer surgery.SAIF features a simple surgical procedure and a short time for flap taking.ALTF provides sufficient amount of tissue to cover the scars left by the surgery,reduce donor site complications,and benefit the recovery of swallowing and speech functions.

关 键 词：舌癌 颏下岛状皮瓣 股前外侧皮瓣 修复 重建 

分 类 号：R739.86[医药卫生—肿瘤]