胸背动脉穿支皮瓣与前臂皮瓣修复口腔癌术后缺损的疗效及美观度比较  

Comparison of the efficacy and aesthetics of thoracodorsal arterial perforator flap and forearm flap in repairing postoperative defect of oral cancer

作　　者：姚麟[1] 王榆娴 邓璋[1] YAO Lin;WANG Yu-xian;DENG Zhang(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》2024年第12期732-736,共5页Journal of Clinical Stomatology

摘　　要：目的:比较胸背动脉穿支皮瓣与前臂皮瓣修复口腔癌术后缺损的疗效及其对术后美观度的影响。方法:收集2020年4月~2024年4月在梅州市人民医院接受手术的口腔癌患者114例,61例采用胸背动脉穿支皮瓣进行修复,53例采用前臂皮瓣进行修复。收集患者的一般资料、原发肿瘤部位及手术治疗方式,统计分析两组皮瓣围手术期指标、术后生存质量及供区美观度。结果:围手术期指标中,胸背动脉穿支皮瓣组制备皮岛长度和皮岛面积大于前臂皮瓣组(P<0.05);两组围手术期并发症发生率差异无统计学意义(P>0.05)。生存质量评分中,胸背动脉穿支皮瓣组外貌评分优于前臂皮瓣组(P<0.05)。患者瘢痕评分中,两组在厚度、瘙痒或疼痛程度及硬度比较,差异无统计学意义(P>0.05);胸背动脉穿支皮瓣组平整度及颜色评分高于前臂皮瓣组(P<0.05)。观察者瘢痕评分中,两组在厚度、顺应度及充血程度比较均无统计学差异(P>0.05)。结论:胸背动脉穿支皮瓣组织量更大,术后修复外观效果较好,术后供区美观效果良好,可作为口腔癌术后缺损的皮瓣选择。Objective:To compare the effect of thoracodorsal arterial perforator flap and forearm flap on postoperative defect of oral cancer and its effect on postoperative aesthetics.Methods:A total of 114 patients with oral cancer who underwent surgery in Meizhou People’s Hospital from April 2020 to April 2024 were collected,61 cases were repaired with thoracodorsal arterial perforator flap and 53 cases were repaired with forearm flap.General data,primary tumor site and surgical treatment were collected.Perioperative indexes,postoperative quality of life and donor area aesthetics of the two groups of flaps were statistically analyzed.Results:In the perioperative period,the length and area of the skin island prepared by thoracodorsal arterial perforator flap group were larger than those of forearm flap group(P<0.05).There was no significant difference in perioperative complication rate between the two groups(P>0.05).In the quality of life score,the appearance score of the thoracodorsal arterial perforator flap group was better than that of the forearm flap group(P<0.05).In the scar score of patients,there was no statistically significant difference in thickness,itching or pain degree and hardness between the two groups(P>0.05),the flatness and color scores of the thoracodorsal arterial perforator flap were higher than those of the fore-arm flap group(P<0. 05). In observer scar scores,there were no significant differences in thickness,compliance and congestionbetween the two groups(P>0. 05). Conclusion:The thoracodorsal arterial perforator flap has larger tissue volume,betterrepair appearance,and good aesthetic effect of donor area,which can be used as the choice of flap for postoperative defects oforal cancer.

关 键 词：胸背动脉穿支皮瓣 口腔癌 修复重建 美观度 

分 类 号：R782.2[医药卫生—口腔医学]