游离前臂皮瓣与颏下岛状瓣在口腔癌术后缺损修复中的对比研究  

Comparative Study Between Free Forearm Flap and Submental Island Flap in Postoperative Oral Defect after Oral Cancer

作　　者：肖艳红[1] 邱淑娴 徐莉 XIAO Yanhong;QIU Shuxian;XU Li(Department of Plastic Surgery,Xiangyang Central Hospital,Affi liated Hospital of Hubei University of Arts and Science,Xiangyang 441021,Hubei,China)

机构地区：[1]襄阳市中心医院,湖北文理学院附属医院整形科,湖北襄阳441021

出　　处：《中国美容医学》2022年第2期13-17,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:比较游离前臂皮瓣与颏下岛状瓣对口腔癌术后缺损的修复效果。方法:回顾性分析2018年7月-2019年7月笔者医院口腔颌面外科收治的83例行口腔癌术后组织缺损修复的患者。根据术式的不同将其分为A组(n=32,行游离前臂皮瓣修复),B组(n=51,行颏下岛状瓣修复)。比较两组手术时间、术中平均出血量、皮瓣成活率、术后受区功能、术后供区不良情况发生率、患者满意度等情况。结果:A组手术时间、术中平均出血量均显著高于B组,差异具有统计学意义(P<0.05)。两组皮瓣成活率相比,差异无统计学意义(P>0.05)。术后两组患者咀嚼吞咽功能、吐字发音功能均逐渐恢复,但两组各功能评分比较无明显差异(P>0.05)。A组供区瘢痕增生、色素沉着、感染坏死、麻木或感觉异常、暂时性功能障碍的发生率均显著高于B组(P<0.05)。A组满意度显著低于B组(P<0.05)。结论:游离前臂皮瓣与颏下岛状瓣均可对口腔癌术后缺损进行较好修复,在条件允许下,颏下岛状瓣是较好的选择。Objective To compare the effect of free forearm flap with submental island flap in repairing postoperative defect for patients after oral cancer.Methods From July 2018 to July 2019,a retrospective analysis was performed on 83 patients with tissue defect repair after oral cancer surgery admitted to the Department of Oral and Maxillofacial Surgery of the author’s hospital.They were divided into group A (n=32,repaired with free forearm flap) and group B (n=51,repaired with submental island flap) according to different surgical methods.The operation time,average intraoperative blood loss,flap survival rate,postoperative function of recipient site,incidence of postoperative adverse conditions of donor site,and patient satisfaction were compared between the two groups.Results The operation time and average intraoperative blood loss in group A were significantly higher than those in group B,and the differences were statistically significant (P<0.05).There was no significant difference in the survival rate of flaps between the two groups (P>0.05).After operation,the masticatory and swallowing functions,enunciation and pronunciation of the patients in the two groups gradually recovered,but there was no significant difference in the functional scores between the two groups (P>0.05).The incidence rates of scar hyperplasia,pigmentation,infection and necrosis,numbness or paresthesia,and temporary dysfunction in the donor site of group A were significantly higher than those of group B (P<0.05).The satisfaction rate of group A was significantly lower than that of group B (P<0.05).Conclusion Both the free forearm flap and the submental island flap can be used to repair the postoperative defects of oral cancer,and the submental island flap is a better choice if the conditions permit.

关 键 词：前臂皮瓣 颏下岛状瓣 口腔癌 术后缺损 修复 

分 类 号：R739.85[医药卫生—肿瘤]