不同皮瓣修复口腔颌面部肿瘤手术缺损的效果及术后美观比较  

Effect and postoperative aesthetic comparison of different skin flaps in repairing surgical defects of oral and maxillofacial tumors

作　　者：曾伟 ZENG Wei(Department of Stomatology,People’s Hospital of Ningxiang,Hunan,Ningxiang 410600,China)

机构地区：[1]湖南省宁乡市人民医院口腔科,湖南宁乡410600

出　　处：《中国医药科学》2023年第15期181-185,共5页China Medicine And Pharmacy

摘　　要：目的探讨桡侧前臂皮瓣与股前外侧皮瓣在口腔颌面部肿瘤根治术后缺损修复中的效果。方法选取2014年4月至2021年3月宁乡市人民医院口腔科采用桡侧前臂皮瓣或股前外侧皮瓣进行口腔颌面部肿瘤根治术后缺损修复的86例患者资料,根据不同皮瓣修复方式分为前臂组与股外侧组,其中前臂组38例、股外侧组48例。比较两组患者围手术期相关指标、术后6个月语言功能及吞咽功能、术前及术后1 d白细胞介素与血清唾液酸水平、术后美观度以及术后1个月并发症发生率及供皮区与植皮区感染发生率。结果前臂组皮瓣制备时间短于股外侧组,差异有统计学意义(P<0.05);前臂组术中出血量高于股外侧组,差异有统计学意义(P<0.05);但两组手术时间、皮瓣成活率比较,差异无统计学意义(P>0.05);两组患者语言功能及吞咽功能比较,差异无统计学意义(P>0.05);术后1 d两组患者白细胞介素与血清唾液酸水平较术前均有明显改善,差异有统计学意义(P<0.05);但两组患者术前及术后1 d白细胞介素与血清唾液酸水平组间比较,差异无统计学意义(P>0.05);术后1个月,两组患者自主评价术后美观度厚度、瘙痒程度、平整度以及颜色各项评分比较,差异无统计学意义(P>0.05);医师对两组患者术后美观度厚度、顺应度、充血程度以及色泽各项评分比较,差异无统计学意义(P>0.05);术后1个月股外侧组患者并发症总发生率低于前臂组,差异有统计学意义(P<0.05)。结论股前外侧皮瓣与前臂皮瓣在口腔颌面肿瘤切除术后缺损组织移植修复术中有着较为相当的修复及术后美观效果,股前外侧皮瓣在减少并发症方面的优势更为突出。Objective To explore the effect of radial forearm flap and anterolateral thigh flap in defect repair after radical resection of oral and maxillofacial tumors.Methods The data of 86 patients who underwent defect repair with radial forearm flap or anterolateral thigh flap after radical resection of oral and maxillofacial tumors in the Department of Stomatology,People’s Hospital of Ningxiang from April 2014 to March 2021 were selected.The patients were divided into the forearm group(38 patients)and the anterolateral thigh group(48 patients)according to different flap repair methods.Perioperative related indexes,language function and swallowing function 6 months after operation,levels of interleukin and serum sialic acid before operation and 1 day after operation,postoperative aesthetic degree,incidence of complications 1 month after operation and incidence of infection in donor site and graft site were compared between the two groups.Results The flap preparation time of the forearm group was shorter than that of the anterolateral thigh group,with statistically significant difference(P<0.05).The blood loss in flap transplantation of the forearm group was higher than that of the anterolateral thigh group,with statistically significant difference(P<0.05).However,there were no significant differences in operation time and flap survival rate between the two groups(P>0.05).There were no significant differences in language function and swallowing function between the two groups(P>0.05).One day after operation,the levels of interleukin and serum sialic acid in the two groups were significantly improved compared with those before operation,with statistically significant differences(P<0.05).However,there were no significant differences between the two groups in the levels of interleukin and serum sialic acid before operation and 1 day after operation(P>0.05).One month after operation,there were no significant differences in the scores of postoperative aesthetic degree,thickness,itching degree,flatness and color evaluated by

关 键 词：口腔颌面部肿瘤 桡侧前臂皮瓣 股前外侧皮瓣 术后美观度 

分 类 号：R739.8[医药卫生—肿瘤]