窄蒂鼻唇沟皮下蒂皮瓣在鼻部及鼻旁恶性肿瘤切除后创面修复中的应用  被引量:3

Application of subcutaneous pedicle flap of narrow pedicle nasolabial fold in wound repair after resection of nasal and paranasal malignant tumors

在线阅读下载全文

作  者:李旭文[1] 葛秀玉 宋培军[1] 徐静[1] Li Xuwen;Ge Xiuyu;Song Peijun;Xu Jing(Department of Plastic Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区:[1]蚌埠医学院第一附属医院整形外科,蚌埠233004

出  处:《中华解剖与临床杂志》2023年第8期527-532,共6页Chinese Journal of Anatomy and Clinics

摘  要:目的探讨窄蒂鼻唇沟皮下蒂皮瓣在鼻部及鼻旁恶性肿瘤切除术后修复面部缺损的效果。方法回顾性队列研究。纳入蚌埠医学院第一附属医院整形外科2018年6月—2022年6月收治的鼻部及鼻旁体表恶性肿瘤患者40例,其中男13例、女27例,年龄52~93(69±12)岁。患者均行肿瘤扩大切除术,根据肿瘤切除后创面修复方法不同分为2组:对照组20例,采用传统的局部转位皮瓣修复;观察组20例,采用窄蒂鼻唇沟皮下蒂推进皮瓣修复。观察并比较2组患者的临床基线资料,皮瓣面积、皮瓣蒂部宽度、皮瓣面积与蒂部宽度比值、手术时间、术中出血量、皮瓣存活率、供瓣区直接缝合率等围术期指标,术后6个月温哥华瘢痕量表(VSS)评分,以及术后创面感染、皮瓣下积液、创面出血、皮瓣对周围组织牵拉、蒂部“猫耳”形成等并发症发生情况。结果2组患者年龄、性别、住院时间以及肿瘤性质、大小、部位等基线资料比较,差异均无统计学意义(P值均>0.05)。观察组皮瓣面积为(6.90±1.94)cm^(2),对照组为(7.80±2.24)cm^(2),差异无统计学意义(t=1.36,P=0.182)。观察组皮瓣蒂部宽度(0.98±0.29)cm、皮瓣面积与蒂宽比值7.35±2.75、手术时间(70.5±16.7)min、术中出血量(47.5±8.5)mL,对照组依次为(2.93±0.65)cm、2.75±0.82、(83.5±19.9)min、(60.5±15.0)mL,组间比较差异均有统计学意义(t=12.25、7.17、2.24、3.36,P值均<0.05)。观察组与对照组皮瓣存活率分别为95.0%(19/20)和90.0%(18/20),差异无统计学意义(χ^(2)=0.00,P=1.000)。观察组供瓣区直接缝合率为95.0%(19/20),高于对照组的60.0%(12/20),差异有统计学意义(χ^(2)=5.16,P=0.023)。术后6个月观察组血管循环VSS评分为(1.40±0.99)分,对照组为(1.65±0.81)分,差异无统计学意义(t=0.87,P=0.388);观察组皮瓣色泽、柔软度、厚度VSS评分及VSS总分分别为(0.90±0.64)、(2.00±1.03)、(1.30±0.92)、(5.60±3.27)分,对照组依次为(1.45±Objective This study aimed to investigate the application effect of subcutaneous pedicle flap of narrow pedicle nasolabial fold on the repair of facial defects after resection of nasal and paranasal malignant tumors.Methods A retrospective cohort study was conducted.From June 2018 to June 2022,40 patients were admitted to the Department of Plastic Surgery of the First Affiliated Hospital of Bengbu Medical College for defect repair after resection of malignant tumors of the nasal and paranasal body surface.Among them,13 were males and 27 were females,aged 52-93(69±12)years.According to the different treatment methods,the subjects were divided into two groups:the control group involving 20 cases using traditional local flap repair,and the observation group involving 20 cases repaired by narrow pedicle nasolabial fold subcutaneous peduncular flap.The clinical baseline data of the two groups were observed and compared.These data included perioperative indicators such as flap area,flap peduncle width,ratio of flap area to peduncle width,operation time,intraoperative blood loss,flap survival rate,direct suture rate of donor valve,Vancouver scar scale(VSS)score,incision infection,subflap effusion,postoperative hemorrhage,stretching of surrounding tissues,and"cat ear"formation of pedic.Results No significant differences existed in the baseline data of age,sex,tumor nature,size,location and length of hospital stay between the two groups(all P values>0.05).The flap area was(6.90±1.94)cm^(2)in the observation group and(7.80±2.24)cm^(2)in the control group,and there was no significant difference between the two groups(t=1.36,P=0.182).The width of the flap pedicle was(0.98±0.29)cm,the ratio of flap area to pedicle width was 7.35±2.75,the operation time was(70.5±16.7)min,and the intraoperative blood loss was(47.5±8.5)mL in the observation group,and those were(2.93±0.65)cm,2.75±0.82,(83.5±19.9)min,and(60.5±15.0)mL in the control group,respectively,and the differences were statistically significant between the two gro

关 键 词:外科皮瓣 窄蒂鼻唇沟皮下蒂皮瓣 鼻部及鼻旁 恶性肿瘤 创面修复 

分 类 号:R739.62[医药卫生—肿瘤]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象