颏下岛状皮瓣与股前外侧皮瓣在口腔癌术后软组织缺损修复中的应用  

Application of submental island flap and anterior lateral thigh flap in the repair of soft tissue defects after oral cancer surgery

作　　者：李茁 刘新璐 LI Zhuo;LIU Xinlu(Radiology Intervention Room,Nanyang Central Hospital,Henan Province,473000,China;Department of Stomatology,Nanshi Hospital,Henan Province,473000,China)

机构地区：[1]南阳市中心医院放射介入室,河南南阳473000 [2]南阳市南石医院口腔科,河南南阳473000

出　　处：《中国医疗美容》2024年第12期45-49,共5页China Medical Cosmetology

摘　　要：目的比较颏下岛状皮瓣与股前外侧皮瓣对口腔癌术后致软组织缺损修复效果及其安全性,旨在为临床提供借鉴。方法选取2019年1月至2023年10月南阳市中心医院行口腔癌根治术即可行皮瓣修复患者的临床资料进行回顾性分析,根据皮瓣来源不同,将其分为颏下皮瓣组和股前皮瓣组,比较两组患者一般资料、肿瘤位置、肿瘤分期、肿瘤直径、淋巴结转移、皮瓣范围、皮瓣制备时间、手术时间、术中出血量、住院时间、术后皮瓣存活情况、并发症发生情况、美学效果及患者满意度等。结果颏下皮瓣组纳入43例,股前皮瓣组纳入37例,两组患者在一般资料、肿瘤位置、肿瘤分期、肿瘤直径等方面比较,差异无统计学意义(P>0.05)。股前皮瓣组软组织缺损面积为(39.34±4.18)cm^(2),大于颏下皮瓣组口腔软组织缺损面积(37.25±3.86)cm^(2),组间比较差异有统计学意义(t=2.324,P=0.023)。颏下皮瓣组皮瓣制备时间、手术时间均较股前皮瓣组短,术中出血量较股前皮瓣组少,差异有统计学意义(P<0.05);住院时间组间比较差异具无统计学意义(P>0.05)。颏下皮瓣组皮瓣存活率为100%,高于股前皮瓣组86.49%,差异有统计学意义(χ^(2)=4.106,P=0.043)。两组手术部位皮肤厚度、顺应度、充血程度、柔软度以及色泽度等美学效果比较,差异无统计学意义(P>0.05)。颏下皮瓣组术后并发症发生率为2.33%,低于股前皮瓣组18.92%,差异有统计学意义(χ^(2)=4.381,P=0.036);主观满意度为90.69%,低于股前皮瓣组91.89%,差异无统计学意义(χ^(2)=0.045,P=0.835)。结论颏下岛状皮瓣与股前外侧皮瓣均能够满足口腔癌致软组织缺损修复对皮瓣的要求,美学效果显著,均是安全可行的修复方法。颏下岛状皮瓣与缺损部位临近,可做带蒂皮瓣旋转,能够有效提升皮瓣存活率,但皮瓣有限,对于较大面积软组织缺损者,股前外侧皮瓣适应性可能更高。Objective Comparing the effectiveness and safety of submental island flap and anterior lateral thigh flap in repairing soft tissue defects after oral cancer surgery,aiming to provide reference for clinical practice.Methods A retrospective analysis was conducted on the clinical data of patients who underwent oral cancer radical surgery and feasible skin flap repair in our hospital from January 2019 to October 2023.According to the different sources of the skin flaps,they were divided into submental skin flap group and anterior thigh skin flap group.The general information,tumor location,tumor stage,tumor diameter,lymph node metastasis,skin flap range,skin flap preparation time,surgical time,intraoperative blood loss,hospitalization time,postoperative skin flap survival,complications,aesthetic effects,and patient satisfaction of the two groups were compared.Results The chin flap group included 43 cases,and the thigh flap group included 37 cases.There was no statistically significant difference between the two groups in terms of general information,tumor location,tumor staging,tumor diameter,etc.(P>0.05).The soft tissue defect area of the anterior thigh flap group was(39.34±4.18)cm~2,which was larger than the oral soft tissue defect area of the submental flap group(37.25±3.86)cm~2.The difference between the groups was statistically significant(t=2.324,P=0.023).The preparation time and surgical time of the submental flap group were shorter than those of the anterior thigh flap group,and the intraoperative blood loss was less than that of the anterior thigh flap group,with statistical significance(P<0.05);There was no statistically significant difference in hospitalization time between groups(P>0.05).The survival rate of the submental flap group was 100%,which was higher than that of the anterior thigh flap group at 86.49%,and the difference was statistically significant(χ~2=4.106,P=0.043).There was no statistically significant difference in aesthetic effects such as skin thickness,compliance,congestion,softness,an

关 键 词：颏下岛状皮瓣 股前外侧皮瓣 口腔癌 软组织缺损 整形修复 美学效果 

分 类 号：R73[医药卫生—肿瘤]