游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后皮瓣失活的影响因素  

Study on the Influencing Factors of Flap Inactivation After Free Flap Graft Repair for Oral and Maxillofacial Tumors

作　　者：尚瑞芬 刘霞[1] 李平[1] SHANG Ruifen;LIU Xia;LI Ping(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052)

机构地区：[1]郑州大学第一附属医院,450052

出　　处：《实用癌症杂志》2023年第8期1381-1383,1387,共4页The Practical Journal of Cancer

摘　　要：目的 探讨影响游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后皮瓣失活的相关因素。方法 回顾性分析2019年12月至2021年2月在郑州大学第一附属医院行游离皮瓣移植修复治疗的89例口腔颌面部肿瘤患者临床资料。术后观察皮瓣存活情况,并分析皮瓣失活的相关影响因素。结果 术后皮瓣失活率为14.61%(13/89),其中不完全失活12例,完全失活1例。单因素分析显示:口腔感染、合并糖尿病、白蛋白(ALB)、纤维蛋白原(FIB)水平与口腔颌面部肿瘤术后皮瓣失活有关(P<0.05),年龄、缺损部位、性别、淋巴结转移、合并高血压、高血脂和肿瘤最大直径、皮瓣来源、凝血酶原时间(PT)与口腔颌面部肿瘤术后皮瓣失活无关(P>0.05);多因素分析显示:合并糖尿病、口腔感染、ALB水平<35 g/L、FIB水平≥4 g/L是口腔颌面部肿瘤术后皮瓣失活的高危因素(P<0.05)。结论 游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后的皮瓣失活与合并糖尿病、口腔感染、ALB水平降低、FIB水平升高有关,临床需加以注意。Objective To investigate the factors affecting the flap graft repair of oral and maxillofacial tumors.Methods The clinical data of 89 patients with oral and maxillofacial tumors treated with free flap graft and repair were retroanalyzed.Flap survival was observed after surgery and factors associated with flap inactivation after free flap graft repair of oral and maxillofacial tumors were analyzed.Results The postoperative flap inactivation rate was 14.61%(13/89),Of these,12 were incomplete inactivated,1 case of complete inactivation;Univariate analysis showed that oral infection,combined diabetes,albumin(ALB),and fibrinogen(FIB) levels were associated with postoperative flap inactivation of oral and maxillofacial tumors(P<0.05);Age,defect site,sex,lymph node metastasis,combined hypertension,hyperlipidemia and tumor maximum diameter,flap origin,prothrombin time(PT) were not associated with postoperative flap inactivation of oral and maxillofacial tumors(P>0.05);Multivariate analysis showed that combined diabetes,oral infection,ALB level <35 g/L,and FIB level 4 g/L were high risk factors for flap inactivation after oral and maxillofacial tumors(P<0.05).Conclusion Inactivation of free flap transplantation after repairing oral and maxillofacial tumors is associated with combined diabetes mellitus,oral infection,decreased ALB level and increased FIB level,which should be paid to clinical attention.

关 键 词：口腔颌面部肿瘤 游离皮瓣移植修复 皮瓣失活 影响因素 

分 类 号：R739.8[医药卫生—肿瘤]