带皮神经游离股前外侧皮瓣在舌癌根治术后重建中的临床应用  

The clinical effeet of free anterior lateral thigh flap with cutaneous nerve on repair and reconstruction after radical operation of tongue cancer

作　　者：杨何平 王月辉[1] 宁炀博 鄢馨栏 杨汉林[1] Yang Heping;Wang Yuehui;Ning Yangbo;Yan Xinlan;Yang Hanlin(Department of Stomatology,Hunan Province People's Hospital,Changsha 410005,China)

机构地区：[1]湖南省人民医院口腔科,长沙410005

出　　处：《中国医师杂志》2021年第11期1619-1622,共4页Journal of Chinese Physician

基　　金：湖南省自然科学基金(2019JJ4028)。

摘　　要：目的评价带皮神经游离股前外侧皮瓣(ALTF)在舌癌根治术后重建中的临床应用效果。方法回顾性选取2015年10月至2020年10月湖南省人民医院口腔科行舌癌根治术的患者79例, 根据治疗方法分为观察组(38例)和对照组(41例)。观察组采用同期带皮神经游离ALTF重建, 对照组采用同期失皮神经游离ALTF重建。观察两组皮瓣存活情况, 并评价再造舌功能及形态等情况。结果两组患者皮瓣均全部成活, 血运良好, 伤口均Ⅰ期愈合, 无感染及动脉危象病例发生, 患者再造舌体外观较丰满, 表现有轻度萎缩。观察组患者在语言清晰度、咀嚼效率、感觉优良率和华盛顿大学生存质量调查表(UW-QOL)得分等方面均显著优于对照组(P<0.05)。结论采用带皮神经游离ALTF行舌癌根治术后重建, 可明显改善再造舌的感觉功能, 提高患者的生存质量。Objective To evaluate the clinical effect of free anterior lateral thigh flap(ALTF)with cutaneous nerve on repair and reconstruction after radical operation of tongue cancer.Methods 79 patients with tongue cancer who underwent radical resection in the stomatology department of Hunan Provincial People's Hospital from October 2015 to October 2020 were selected and divided into observation group(38 cases)and control group(41 cases)according to the treatment method.The observation group was reconstructed with free ALTF with cutaneous nerve,and the control group was reconstructed with free ALTF without cutaneous nerve.The survival of the flap was observed and the function and morphology of the reconstructed tongue were evaluated.Results All flaps survived and had good blood supply;the blood supply was good,the wounds healed in the first stage,and there were no cases of infection and arterial erisis.The appearance of the reconstructed tongue was plump and showed mild atrophy.The observation group was significantly better than the control group in terms of language clarity,masticatory efficiency,sensory excellence rate and University of Washington Quality of Life questionnaire(UW-QOL)score(P<0.05).Conclusions The ALTF with cutaneous nerve for repair and reconstruction after radical operation of tongue cancer,can significantly improve the reconstruction of tongue sensory function and the quality of life of patients.

关 键 词：舌肿瘤 口腔外科手术 股前外侧皮瓣 重建 

分 类 号：R739.86[医药卫生—肿瘤]