口腔颌面部肿瘤切除及游离皮瓣修复重建术后患者早期恢复质量及与DAH30的关系  

A Study on early quality of recovery of patients undergoing oral and maxillofacial tumour resection and free flap reconstruction surgery and its relationship with DAH30

作　　者：张瑶 郭俊 李慧 祝文 刘冰 张惠 ZHANG Yao;GUO Jun;LI Hui;ZHU Wen;LIU Bing;ZHANG Hui(State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture,Department of Anesthesiology,School of Stomatology,The Fourth Military Medical University,Xi'an 710032,Shaanxi Province,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔生物工程技术研究中心,空军军医大学口腔医院麻醉科,陕西西安710032

出　　处：《中国口腔颌面外科杂志》2025年第2期110-116,共7页China Journal of Oral and Maxillofacial Surgery

基　　金：国家口腔疾病临床医学研究中心资助课题(LCA202005);空军军医大学临床研究项目(2023LC2341)。

摘　　要：目的:探讨口腔颌面部肿瘤切除及游离皮瓣修复重建术后患者早期恢复质量(quality of recovery,QoR)情况,分析其与术后30天存活天数和住家天数(days at home alive up to 30 days after surgery,DAH30)的关系。方法:采用前瞻性、单中心队列研究,选择2022年9月—2023年10月在空军军医大学口腔医院全麻下行口腔颌面部肿瘤切除及游离皮瓣修复重建手术的患者,采用QoR-15量表分别于术前1天、术后第1天和第2天进行评估,根据术后第1天的QoR-15评分对患者分组,主要结局是术后早期QoR情况及术后第1天QoR与DAH30的关系。采用SAS 9.4软件包对数据进行统计学分析。结果:共纳入分析患者251例,其中术后第1天QoR较差86例(34.26%)、中等165例(65.74%),术后第2天QoR较差25例(9.96%)、中等213例(84.86%)、良好13例(5.18%),术后第1天QoR较差组患者DAH30的中位数为18 d,中等组为20 d,差异有统计学意义(P=0.003)。结论:口腔颌面部肿瘤切除及游离皮瓣修复重建术后患者早期QoR以中等为主,提高该类患者术后早期QoR有助于改善预后。PURPOSE:To investigate the early quality of recovery(QoR)of patients undergoing oral and maxillofacial tumour resection and free flap reconstruction surgery,and to analyze the relationship between QoR and days at home alive up to 30 days after surgery(DAH30).METHODS:A prospective,single-centre,cohort study was conducted on patients who were admitted to our hospital from September 2022 to October 2023 and scheduled to undergo oral and maxillofacial tumour resection and free flap reconstruction surgery under general anaesthesia.QoR-15 scale was used to evaluate the QoR on the day before surgery,the first day after surgery,and the second day after surgery.The patients were grouped according to the QoR-15 score on the 1st day after surgery,and the main results were the situation of QoR in the early postoperative period and the relationship between QoR of the 1st postoperative day and DAH30.SAS 9.4 software package was used for data analysis.RESULTS:A total of 251 patients were analyzed,the QoR on the 1st day after surgery was 86(34.26%)cases as poor,165(65.74%)cases as moderate,as well as 25(9.96%)cases as poor,213(84.86%)cases as moderate and 13(5.18%)cases as good on the second day after surgery.On the first day after surgery,the median DAH30 of patients with poor QoR was 18 days,and that of patients with moderate QoR was 20 days,and the difference was statistically significant(P=0.003).CONCLUSIONS:The early QoR of patients undergoing oral and maxillofacial tumour resection and free flap reconstruction surgery is mainly moderate.Enhancing the quality of recovery of such patients on the first day after surgery is beneficial to improve prognosis.

关 键 词：口腔颌面部肿瘤 游离皮瓣修复重建手术 恢复质量 DAH30 QoR-15量表 

分 类 号：R739.8[医药卫生—肿瘤]