胸背动脉穿支皮瓣和股前外侧皮瓣修复舌癌术后缺损的效果比较  

Study of the application of thoracodorsal arterial perforator flap and anterolateral thigh flap in soft tissue defect repair after tongue cancer surgery

作　　者：姚麟[1] 邓璋[1] 曾威[1] YAO Lin;DENG Zhang;ZENG Wei(Department of Oral and Maxillofacial Surgery,Meizhou People’s Hospital,Guangdong Meizhou 514031,China)

机构地区：[1]梅州市人民医院口腔颌面外科,广东梅州514031

出　　处：《临床口腔医学杂志》2023年第11期672-675,共4页Journal of Clinical Stomatology

摘　　要：目的:比较胸背动脉穿支皮瓣和股前外侧皮瓣在舌癌术后软组织缺损修复重建中的应用效果。方法:通过对梅州市人民医院口腔颌面外科在2019年1月~2023年2月完成的66例舌癌术后软组织缺损修复的患者进行前瞻性研究,比较胸背动脉穿支皮瓣与股前外侧皮瓣供区并发症以及供区美观效果的差别。应用视觉模拟量表和华盛顿大学生存质量调查表第4版分析术后外观结果以及生活质量。结果:胸背动脉穿支皮瓣组供区瘢痕、色素沉着、感觉异常、功能障碍及总体并发症发生率与股前外侧皮瓣组的差异有统计学意义(P<0.001),视觉模拟量表和华盛顿大学生存质量调查表结果提示胸背动脉穿支皮瓣组对供区美观满意度较股前外侧皮瓣组高(P<0.05)。结论:在舌癌术后软组织缺损修复中,胸背动脉穿支皮瓣和股前外侧皮瓣均可以取得了良好的修复效果,对美观要求较高的患者在血管质量允许的条件下可以优先选择胸背动脉穿支皮瓣。Objective:To compare the application of the thoracodorsal artery perforator flap and the anterolateral thigh flap in the reconstruction of soft tissue defects after tongue cancer surgery.Methods:A prospective cohort study was conducted on 66 cases of soft tissue defects after tongue cancer surgery in the department of oral and maxillofacial surgery of Meizhou People’s Hospital from January 2019 to February 2023.The difference in the incidence of donor site complications and aesthetic effect between the thoracodorsal artery perforator flap and the anterolateral thigh flap was compared.The postoperative appearance results and quality of life of 66 patients were measured by using the visual analog scale(VAS)and the fourth edition of the University of Washington quality of life scale(UW-QOL).Results:After surgical exploration,the incidence of scars,pigmentation,paresthesia,dysfunction,and overall complications in the donor area of the thoracodorsal artery perforator flap group was statistically significant compared to the anterolateral femoral flap group(P<0.001).The results of the scores of VAS and UW-QOL indicated that the satisfaction of the thoracodorsal artery perforator flap group with donor site aesthetics was higher than that of the anterolateral femoral flap group(P<0.05).Conclusion:In the reconstruction of soft tissue defects after tongue cancer surgery,both the thoracodorsal artery perforator flap and the anterolateral thigh flap can achieve good repair results.For patients with high aesthetic requirements,the thoracodorsal artery perforator flap may be chosen under the condition of vascular quality.

关 键 词：胸背动脉穿支皮瓣 股前外侧皮瓣 舌癌 修复重建 

分 类 号：R782.2[医药卫生—口腔医学]