前臂桡侧皮瓣和股前外侧皮瓣修复口腔癌切除后软组织缺损临床效果比较  

Comparison of clinical outcomes of forearm radial flap and anterolateral thigh flap for repairing soft tissue defects after oral cancer resection

作　　者：朱江[1] 须无双 马子涵 项毓铖 石婉莹 吴森斌[1] 宋冬惠[1] Zhu Jiang;Xu Wushuang;Ma Zihan;Xiang Yucheng;Shi Wanying;Wu Senbin;Song Donghui(Department of Stomatology,Affiliated Hospital of Nantong University,Nantong 226000,China)

机构地区：[1]南通大学附属医院口腔科,南通226000

出　　处：《中华整形外科杂志》2024年第9期992-1001,共10页Chinese Journal of Plastic Surgery

基　　金：南通市科技局市级科技计划项目(JCZ19112)。

摘　　要：目的比较前臂桡侧皮瓣与股前外侧皮瓣在口腔癌术后软组织缺损中的修复效果, 并探讨其适应证。方法回顾性分析南通大学附属医院口腔科2019年5月至2023年2月收治的口腔癌患者临床资料, 根据修复方法分为前臂桡侧皮瓣组和股前外侧皮瓣组。从以下几个方面对2组进行比较:(1)手术情况(包括口腔癌切除后缺损面积、皮瓣面积、皮瓣制备时间、手术时间)及住院时间。(2)术前1 d和术后1 d炎性指标, 包括白细胞介素6和C反应蛋白含量。(3)皮瓣成活情况。(4)术后6个月内皮瓣供区并发症和口腔受区感染发生率。(5)术后6个月, 由1位参与治疗的主治医生参考华盛顿大学生存质量问卷(UW-QOL)评估患者口腔功能, 包括口腔开颌、言语、饮食功能。每一项总分均为0~10分, 评分越高表明口腔功能恢复越好。(6)术后2、4、6个月, 由1位参与治疗的主治医生通过简明健康状况调查问卷(SF-36)评估患者生活质量, 从生理、心理、社会功能3个方面综合评估, 满分100分, 得分越高表明术后患者生活质量越高。(7)术后6个月, 调查患者满意度, 包括满意、基本满意、不满意3个等级, 计算满意率[(满意+基本满意)例数/各组总例数×100%]。采用SPSS 22.0软件对数据进行统计分析。计量资料以±s表示, 组间比较采用t检验;计数资料采用例和(或)百分比表示, 组间比较采用χ^(2)检验。P<0.05表示差异有统计学意义。结果前臂桡侧皮瓣组纳入48例, 男32例, 女16例;年龄(49.3±5.0)岁;体重指数(23.0±1.1) kg/m^(2);病程(6.5±2.1)个月;舌癌21例、口底癌12例、颊癌15例;鳞状细胞癌40例, 基底细胞癌8例。股前外侧皮瓣组纳入32例, 男20例, 女12例;年龄(50.1±5.0)岁;体重指数(23.0±1.0) kg/m^(2);病程(7.0±2.2)个月;舌癌16例、口底癌7例、颊癌9例;鳞状细胞癌27例, 基底细胞癌5例。2组患者性别构成、年龄、体重指数、病程、肿瘤部位Objective To compare the efficacy of radial forearm flap and anterolateral thigh flap in repairing soft tissue defects after oral cancer surgery and to explore their indications.Methods A retrospective analysis was conducted on clinical data of patients with oral cancer treated at the Department of Stomatology,Affiliated Hospital of Nantong University,from May 2019 to February 2023.Patients were divided into two groups based on the repair method:the radial forearm flap group and the anterolateral thigh flap group.The groups were compared in the following aspects.(1)Surgical parameters including defect area after oral cancer resection,flap area,flap preparation time,operation time,and length of hospital stay.(2)Inflammatory markers(interleukin-6 and C-reactive protein levels)measured 1 day before surgery and 1 day after surgery.(3)Flap survival rate was calculated.(4)Complication rates was calculated in the flap donor area and infection rates in the oral recipient area within 6 months postoperatively.(5)Six months postoperatively,the patient’s oral function was assessed by a physician using the University of Washington quality of life scale(UW-QOL).The evaluation included assessments of oral opening,speech,and eating functions.Each parameter was scored on a scale of 0 to 10(higher scores indicated better recovery).(6)Quality of life was assessed using the 36-item short form health survey scale(SF-36)at 2,4 and 6 months postoperatively,with scores ranging from 0 to 100(higher scores indicated better quality of life).(7)Patient satisfaction was assessed at 6 months postoperatively,with satisfaction levels categorized as satisfied,basically satisfied,and dissatisfied.The satisfaction rate was calculated as(satisfied+basically satisfied)cases/total cases in each group×100%.Statistical analysis was performed using SPSS 22.0.Measurement data were expressed as Mean±SD,and comparisons between groups were conducted using t-tests.Count data were expressed as cases and(or)percentages,and comparisons were made using chi-s

关 键 词：口腔肿瘤 前臂桡侧皮瓣 股前外侧皮瓣 软组织缺损 治疗结果 并发症 

分 类 号：R739.8[医药卫生—肿瘤]