去皮化股前外侧穿支皮瓣在头颈恶性肿瘤术后缺损重建中的应用  

Application of deskinned anterolateral thigh perforator flaps in the reconstruction of tissue defects after surgery for head and neck malignant tumors

作　　者：王建洪[1] 胡珍[1] 朱远志 龙盈[1] 罗小邹 李军 罗剑 李雪梅[1] 杨红梅[1] WANG Jian-hong;HU Zhen;ZHU Yuan-zhi;LONG Ying;LUO Xiao-zou;LI Jun;LUO Jian;LI Xue-mei;YANG Hong-mei(Department of Otolaryngology Head and Neck Surgery,the First People's Hospital of Yibin,Yibin 646000,Sichuan,CHINA)

机构地区：[1]宜宾市第一人民医院耳鼻咽喉头颈外科,四川宜宾646000

出　　处：《海南医学》2025年第3期413-416,共4页Hainan Medical Journal

基　　金：2020年四川省宜宾市科技计划项目(编号:2020SF001)。

摘　　要：目的观察去皮化股前外侧穿支皮瓣应用于头颈恶性肿瘤术后组织缺损重建的临床效果。方法回顾性分析2018年6月至2023年2月宜宾市第一人民医院收治的应用去皮化股前外侧穿支皮瓣修复头颈恶性肿瘤术后组织缺损的11例患者的临床资料,统计分析皮瓣存活情况、皮瓣黏膜化时间和并发症情况,并采用安德森吞咽困难量表评估患者吞咽方面的生活质量。结果术后随访时间为8~57个月,无1例患者发生复发及转移。仅1例因皮瓣远端静脉回流障碍发生坏死,其余皮瓣均成活。皮瓣完全黏膜化时间为33~58 d,平均完全黏膜化时间为38 d。安德森吞咽量表总分均值为(85.36±4.29)分,表示患者对自身术后吞咽方面的生活质量比较满意。结论去皮化股前外侧穿支皮瓣用于头颈恶性肿瘤患者术后组织缺损的修复重建,具有黏膜化时间短、患者对自身术后吞咽方面生活质量满意的特点,值得临床推广应用。Objective To observe the clinical effects of deskinned anterolateral thigh perforator flaps on tissue defect reconstruction after surgery for head and neck malignant tumors.Methods From June 2018 to February 2023,the clinical data of 11 patients with tissue defects after head and neck malignant tumor repair via deskinned anterolateral thigh perforator flaps admitted to the First People's Hospital of Yibin were analyzed retrospectively.The survival of the flap,the mucosalization time,and flap complications were statistically analyzed,and the swallowing quality of life was assessed via Anderson Dysphagia Inventory.Results The mean follow-up time was 8-57 months,and there was no recurrence or distant metastasis in any patient.Only 1 patient experienced necrosis of the flap due to obstruction of the distal venous return,while the other flaps survived.The duration of complete mucosalization of the skin flaps ranged from 33 to 58 days,and the average duration of complete mucosalization was 38 days.The average Anderson dysphagia Inventory score was(85.36±4.29)points,which showed that patients were satisfied with the quality of life in swallowing after surgery.Conclusion Application of anterolateral thigh perforator flaps in the reconstruction of tissue defects in patients with malignant head and neck tumors results in short mucosalization time and high patients’satisfaction with quality of life in swallowing,which is worthy of clinical application.

关 键 词：股前外侧皮瓣 头颈肿瘤 组织缺损 重建 生活质量 

分 类 号：R739.91[医药卫生—肿瘤]