游离股前外侧皮瓣方案对口腔颌面软组织缺损患者的修复效果及对血清唾液酸和sIL-2R水平的影响  

Effect of free anterolateral thigh flap on the repair of oral and maxillofacial soft tissue defect and the level of sialic acid, sIL-2R

作　　者：李雄 王东 李双君 余波 张贵梅 张信 LI Xiong;WANG Dong;LI Shuang-jun(Department of Stomatology,Jianyang Hospital Affiliated to Southwest Medical University(Jianyang People's Hospital),Jianyang Sichuan 641400,China;Department of Stomatology,Sichuan Provincial People's Hospital,Chengdu Sichuan 610072,China)

机构地区：[1]西南医科大学附属简阳医院(简阳市人民医院)口腔颌面外科,四川简阳641400 [2]四川省人民医院口腔颌面外科,四川成都610072 [3]自贡市第一人民医院口腔颌面外科,四川自贡643000 [4]资阳市人民医院口腔颌面外科,四川资阳641399

出　　处：《临床和实验医学杂志》2025年第1期50-54,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生健康委员会科研课题项目(编号:20PJ276)。

摘　　要：目的 研究游离股前外侧皮瓣(ALTFF)方案治疗对口腔颌面软组织缺损患者的修复效果及对血清唾液酸、可溶性白细胞介素-2受体(sIL-2R)水平的影响。方法 回顾性选取2020年1月至2023年1月入西南医科大学附属简阳医院(简阳市人民医院)的90例口腔颌面部软组织缺损患者,根据治疗方式不同分为对照组(n=45)与研究组(n=45)。对照组予以游离上臂外侧皮瓣(LAFF)方案治疗,研究组予以ALTFF方案治疗。比较两组患者的皮瓣面积、皮瓣制备时间等围术期指标,血清唾液酸、sIL-2R水平,术后美观度,口腔功能恢复情况和术后并发症发生情况。结果 研究组患者的皮瓣面积、血管蒂长度、动脉管径、静脉管径、皮瓣成功率分别为(65.53±10.15) cm^(2)、(10.15±0.77) cm、(2.03±0.11) mm、(3.21±0.31) mm、100.00%,均高于对照组[(42.12±10.33) cm^(2)、(5.89±0.83) cm、(1.46±0.15) mm、(2.01±0.14) mm、80.00%],差异均有统计学意义(P<0.05);两组患者的皮瓣制备时间、皮瓣塑形率比较,差异均无统计学意义(P>0.05)。术后30 d,两组患者的血清唾液酸、sIL-2R水平均低于术前,且研究组患者术后30 d血清唾液酸、sIL-2R水平分别为(0.56±0.11) mg/L、(1.86±0.52)μg/L,均低于对照组[(0.89±0.21) mg/L、(2.38±0.83)μg/L],差异均有统计学意义(P<0.05)。研究组患者随访6个月术后美观度各项评分均低于对照组,口腔功能恢复情况优于对照组,差异均有统计学意义(P<0.05)。研究组患者的并发症发生率为11.11%,低于对照组(40.00%),差异有统计学意义(P<0.05)。结论 口腔颌面部软组织缺损修复中ALTFF与LAFF方案的皮瓣塑形率相当,ALTFF在皮瓣面积、成功率、美观度、口腔功能上优势更加显著,有利于改善血清指标,降低并发症发生风险。Objective To investigate the repair effect of anterolateral thigh free flap(ALTFF)on oral and maxillofacial soft tissue defect and its influence on serum sialic acid and soluble interleukin-2 receptor(sIL-2R)level.Methods The study method was retrospective analysis.Ninety patients with oral and maxillofacial soft tissue defects admitted to Jianyang Hospital Affiliated to Southwest Medical University(Jianyang People's Hospital)from January 2020 to January 2023 were divided into the control group(n=45)and the study group(n=45)according to different treatment methods.The control group was treated with lateral arm free flap(LAFF),while the study group was treated with free anterolateral thigh flap.The perioperative indexes such as skin flap area,preparation time,serum sialic acid and sIL-2R levels,postoperative aesthetics,oral function recovery and postoperative complications were compared between the two groups.Results The area of skin flap,the length of vessel pedicle,the diameter of artery tube,the diameter of vein tube and the success rate of skin flap in the study group were(65.53±10.15)cm^(2),(10.15±0.77)cm,(2.03±0.11)mm,(3.21±0.31)mm,and 100.00%,respectively,which were higher than those of the control group[(42.12±10.33)cm^(2),(5.89±0.83)cm,(1.46±0.15)mm,(2.01±0.14)mm,and 80.00%],and the differences were statistically significant(P<0.05);there were no statistically significant differences in flap shape shaping rate and flap preparation time between groups(P>0.05).At 30 d after operation,the levels of serum sialic acid and sIL-2R in two groups were lower than those before operation,and the levels of serum sialic acid and sIL-2R in the study group were(0.56±0.11)mg/L,(1.86±0.52)μg/L,respectively,which were lower than those in the control group[(0.89±0.21)mg/L,(2.38±0.83)μg/L],and the differences were statistically significant(P<0.05).After 6 months of follow-up,the aesthetic scores of the study group were lower than those of the control group,and the recovery of oral function was better than that o

关 键 词：口腔颌面部 软组织缺损 游离股外侧皮瓣 移植修复术 唾液酸 可溶性白细胞介素-2受体 

分 类 号：R782.4[医药卫生—口腔医学]