游离前臂皮瓣与股前外侧皮瓣修复口腔癌术后缺损的疗效及对伤口美观度的影响  

Effect of Free Forearm Flap and Anterolateral Thigh Flap on Defect Repair after Oral Cancer Surgery and Its Influence on Wound Aesthetics

作　　者：刘喆 刘敏[1] 葛苏蒙 孙国文[1] LIU Zhe;LIU Min;GE Sumeng;SUN Guowen(Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属口腔医院南京市口腔医院口腔颌面外科,江苏南京210008

出　　处：《中国美容医学》2023年第12期74-77,共4页Chinese Journal of Aesthetic Medicine

基　　金：南京市卫生科技发展专项资金项目计划(编号:YKK22183);南京大学医学院附属口腔医院3456骨干人才资助项目(编号:0222C111)。

摘　　要：目的:分析游离前臂皮瓣(Radial forearm free flap,RFFF)与股前外侧皮瓣(Anterolateral thigh flap,ALTF)在口腔癌术后缺损修复中的效果及对伤口美观度的影响。方法:收集2019年1月-2021年12月笔者医院收治的86例行口腔癌术后缺损修复术患者的临床资料,其中42例应用RFFF修复(RFFF组),44例应用ALTF修复(ALTF组)。记录两组皮瓣成功率、手术相关指标、术后张口度、语音清晰度及术后并发症情况,并在术后1年,使用华盛顿大学生存质量评估问卷进行问卷调查,问卷内容包括口腔功能(吞咽、咀嚼、讲话、味觉、唾液),伤口美观度(外表)等12个项目,评估两组术后1年生存质量。结果:两组皮瓣成功率分别为97.62%、97.73%,差异无统计学意义(P>0.05)。两组皮瓣制作时间、皮瓣面积、手术时间及术后住院时间比较,差异无统计学意义(P>0.05)。两组术后受区并发症比较,差异无统计学意义(P>0.05);RFFF组供区并发症总发生率高于ALTF组(P<0.05)。RFFF组术后3个月张口度及语音清晰度、术后1年外表UW-QOL评分、UW-QOL总分均高于ALTF组(均P<0.05),两组术后1年口腔功能等其他UW-QOL项目评分比较,差异无统计学意义(P>0.05)。结论:RFFF及ALTF均为口腔癌术后缺损修复的理想皮瓣,成功率较高,RFFF皮瓣在术后早期口腔功能恢复及颌面部美观度方面更具优势,ALTF皮瓣供区并发症少,在安全性方面更具优势。Objective To analyze the effect of radial forearm free flap(RFFF)and anterolateral thigh flap(ALTF)on defect repair after oral cancer surgery and the influence on wound aesthetics.Methods The clinical data of 86 patients undergoing defect repair after oral cancer surgery were collected between January 2019 and December 2021,including 42 patients receiving RFFF repair(RFFF group)and 44 patients receiving ALTF repair(ALTF group).The success status of skin flap,surgical-related indicators,postoperative mouth opening and speech clarity and postoperative complications were recorded in both groups.At 1 year after surgery,questionnaire survey was conducted using University of Washington Quality of Life Questionnaire(UW-QOL),including 12 items such as oral function(swallowing,chewing,speech,taste,saliva)and wound aesthetics(appearance).The quality of life was evaluated in both groups at 1 year after surgery.Results The success rates of skin flap in the two groups were 97.62%and 97.73%(P>0.05).There were no statistically significant differences in the skin flap preparation time,flap area,surgical time and postoperative hospital stay between the two groups(P>0.05).There were no statistical differences in postoperative complications in the recipient area between the two groups(P>0.05).The total incidence rate of complications in the donor area in RFFF group was higher than that in ALTF group(P<0.05).Mouth opening and speech clarity at 3 months after surgery and appearance score and total score of UW-QOL at 1 year after surgery were higher in RFFF group than those in ALTF group(all P<0.05),but there were no statistical differences in scores of items such as oral function of UW-QOL at 1 year after surgery between the two groups(P>0.05).Conclusion Both RFFF and ALTF are ideal flaps for defect repair after oral cancer surgery,with a high success rate.RFFF flap has more advantages in early postoperative oral function recovery and maxillofacial aesthetics,and ALTF flap has fewer complications in the donor area and has more advant

关 键 词：口腔癌 缺损修复 前臂皮瓣 股前外侧皮瓣 口腔功能 颌面部 美观度 

分 类 号：R739.81[医药卫生—肿瘤]