20例自体脂肪填充改善口腔癌治疗后皮肤纤维化的效果评价  

Evaluation of autologous fat grafting in improving post-treatment skin fibrosis in 20 patients with oral cancer

作　　者：王钰 钱珍 侯黎莉 王明一[3] WANG Yu;QIAN Zhen;HOU Li-li;WANG Ming-yi(Department of Nursing,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011;School of Nursing,Chengdu University of Traditional Chinese Medicine.Chengdu 610075,Sichuan Province;Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院护理部,上海200011 [2]成都中医药大学护理学院,四川成都610075 [3]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,上海200011

出　　处：《上海口腔医学》2025年第1期68-73,共6页Shanghai Journal of Stomatology

基　　金：上海高水平地方高校创新团队(SHSMU-ZDCX20212802)。

摘　　要：目的:探讨自体脂肪填充用于改善口腔癌患者颈淋巴清扫(颈清)术后颈部皮肤纤维化的临床效果。方法:选取2022年10月—2023年7月在上海交通大学医学院附属第九人民医院行口腔癌切除+颈淋巴清扫术(简称颈清)的患者20例,平均年龄43岁。其中,7例为颈清术后行放疗的患者,13例为单纯颈清未行放疗的患者。根据患者面颈部凹陷程度、皮肤纤维化范围和颈肩功能障碍程度,给予相应体积的自体脂肪填充。填充治疗后3个月复诊,从瘢痕改善情况、肩颈功能、生存质量3方面对颈部皮肤纤维化改善效果进行评价。采用SPSS 26.0软件包对数据进行统计学分析。结果:口腔癌治疗后至填充治疗的时间间隔为11~72个月,脂肪填充量为15~45 mL,所有患者均未发生局部硬结、感染、坏死等并发症。治疗后3个月,患者肩关节评分(CMS)、颈部纤维化症状(VAS)、患者及观察者瘢痕评估量表(PSAS、OSAS)和FACE-Q生存质量评分均优于治疗前,差异有统计学意义(P<0.05)。结论:自体脂肪填充可明显改善颈清术后包括放疗后颈部皮肤纤维化,改善因手术和放疗引起的肩颈功能障碍,并发症发生率较低,值得临床推广。PURPOSE:To evaluate the clinical effect of autologous fat grafting for treating cervical skin fibrosis in patients with oral cancer after neck dissection with or without radiotherapy.METHODS:A total of 20 patients who underwent oral cancer resection and neck dissection in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from October 2022 to July 2023 were enrolled,7 patients were treated with radiotherapy after neck dissection and 13 patients were treated with neck dissection.According to the degree of face-neck depression,the range of fibrosis and the function of neck and shoulder,corresponding volume of autologous fat was used to fill the depression.Three months after treatment,the improvement of cervical skin fibrosis was evaluated in terms of scar improvement,shoulder and neck function,and quality of life.SPSS 26.0 software package was used for statistical analysis of the data.RESULTS:The interval between the treatment of oral cancer and fat filling was 11-72 months,and the dose of fat grafting was 15-45 mL.There were no complications such as local induration,infection and necrosis in all patients.Three months after treatment,the results of Constant-Murley Score(CMS),neck fibrosis symptom(VAS),patient observer scar assessment scale(PSAS,OSAS)and FACE-Q quality of life score were better than those before treatment,and the differences were statistically significant(P<0.05).CONCLUSIONS:Autologous fat grafting can significantly improve the fibrosis of the neck skin after neck dissection with or without radiotherapy,and improve shoulder and neck dysfunction caused by surgery and radiotherapy.This method is worthy of clinical used because of the low rate of complication.

关 键 词：自体脂肪填充 颈淋巴清扫术 皮肤纤维化 肩颈功能 

分 类 号：R739.8[医药卫生—肿瘤]