口腔癌根治同期修复重建术后皮瓣坏死的影响因素分析  

Analysis of influencing factors for skin flap necrosis after simultaneous repair and reconstruction of oral cancer radical surgery

作　　者：胡海琴[1] 屠奕[1] 梁冠冕[2] 王兰[3] 吴清晨 HU Haiqin;TU Yi;LIANG Guanmian;WANG Lan;WU Qingchen(Department of Thyroid surgery,Zhejiang Cancer Hospital,Hangzhou 310022,China)

机构地区：[1]浙江省肿瘤医院甲状腺外科,杭州310022 [2]浙江省肿瘤医院护理部,杭州310022 [3]浙江省肿瘤医院头颈外科,杭州310022

出　　处：《浙江医学》2025年第2期188-190,193,共4页Zhejiang Medical Journal

基　　金：浙江省卫生健康科技计划项目(2022KY633)。

摘　　要：目的探讨口腔癌根治同期修复重建术后皮瓣坏死的影响因素。方法回顾性分析2017年1月至2022年12月浙江省肿瘤医院头颈外科收治的行口腔癌根治同期修复重建术的234例患者的临床资料,将皮瓣切缘颜色发黑、切割无出血视为皮瓣发生坏死,反之为皮瓣未发生坏死,采用多因素logistic回归分析口腔癌根治同期修复重建术后发生皮瓣坏死的影响因素。结果234例研究对象中皮瓣发生坏死33例,未发生坏死201例,术后皮瓣坏死发生率为14.1%。皮瓣发生坏死者和未发生坏死者性别、婚姻、吸烟史、酗酒史、受区部位手术史、术后高凝状态和术后皮瓣是否肿胀比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示有酗酒史、有受区部位手术史、术后出现高凝状态和术后皮瓣肿胀是术后皮瓣坏死的独立危险因素(均P<0.05)。结论有酗酒史、有受区部位手术史、术后出现高凝状态和术后皮瓣肿胀是口腔癌根治同期修复重建术后皮瓣坏死的独立危险因素。对于有高危因素的患者,应予以积极的综合性干预措施,以降低皮瓣坏死的发生风险。Objective To explore the influencing factors for skin flap necrosis after simultaneous repair and reconstruction surgery of oral cancer radical surgery.Methods A retrospective analysis was conducted on the clinical data of 234 patients who underwent simultaneous repair and reconstruction surgery of oral cancer radical surgery at the Department of Head and Neck Surgery of Zhejiang Cancer Hospital from January 2017 to December 2022.The skin flap necrosis was defined by black color in incision edge without bleeding while cutting the local skin;otherwise,it was considered as non-necrosis of skin flap.Logistic regression analysis was used to investigate the influencing factors for skin flap necrosis after simultaneous repair and reconstruction surgery of oral cancer radical surgery.Results Among the 234 study subjects,33 cases had skin flap necrosis and 201 cases did not.The incidence of postoperative skin flap necrosis was 14.1%.There were statistically significant differences between patients with and without skin flap necrosis in gender,marital status,smoking history,alcohol consumption history,surgical history at the recipient site,postoperative hypercoagulability status,and postoperative skin flap swelling(all P<0.05).Multivariate logistic regression analysis showed that a history of alcohol consumption,a history of surgery in the affected area,postoperative hypercoagulability,and postoperative skin flap swelling were independent risk factors for postoperative skin flap necrosis(all P<0.05).Conclusion History of alcohol consumption,surgical history in the affected area,postoperative hypercoagulability,and postoperative skin flap swelling are independent risk factors for postoperative skin flap necrosis.For patients with high-risk factors,active comprehensive intervention measures should be taken to reduce the risk of skin flap necrosis.

关 键 词：口腔癌 缺损 皮瓣坏死 影响因素 

分 类 号：R73[医药卫生—肿瘤]