股前外侧嵌合皮瓣与串联皮瓣修复口腔颌面部肿瘤根治术后缺损的效果比较

邵侠; 屠呈威; 赵磊; 王靖虓; 吴立军

doi:10.16766/j.cnki.issn.1674-4152.000341

股前外侧嵌合皮瓣与串联皮瓣修复口腔颌面部肿瘤根治术后缺损的效果比较

doi: 10.16766/j.cnki.issn.1674-4152.000341

温州医科大学附属第一医院口腔颌面外科, 浙江温州 325000

基金项目:

国家自然科学基金面上项目(81271663)

详细信息

通讯作者:
吴立军,E-mail:biomech@163.com

中图分类号: R739.8;R782.2
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出版历程
- 收稿日期: 2018-01-11
- 网络出版日期: 2022-08-06

Clinical effect comparison of chimeric anterolateral thigh flap and tandem skin flap on repair of oral and maxillofacial tumors after radical surgery

Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的比较股前外侧嵌合皮瓣与串联皮瓣修复口腔颌面部肿瘤根治术后缺损的临床疗效。方法选取2014年12月-2016年12月期间在温州医科大学附属第一医院进行修复口腔颌面部肿瘤根治术后缺损102例患者为研究对象,根据修复术的不同,将患者分为A组(股前外侧嵌合皮瓣修复)、B组(串联皮瓣修复),每组各51例。比较2组患者手术情况(手术时间、皮瓣制作与显微吻合时间、拔除胃管时间、经口进食时间)、术后恢复情况(满意度、外形修复、进食情况、工作情况、口腔闭合、张口度、咀嚼功能、吞咽功能、咬合功能、语言功能)、血清IL-2、sIL-2R、SA水平及术后并发症情况。结果 A组手术时间、拔除胃管时间、经口进食时间明显少于B组(P<0.05),皮瓣制作与显微吻合时间明显多于B组(P<0.05)。术后3个月,A组在满意度、外形修复、工作情况、口腔闭合、咀嚼功能、吞咽功能及语言功能等方面评分明显高于B组(P<0.05),在进食情况、容纳水测试、张口度及咬合功能等方面评分与B组比较差异无统计学意义(P>0.05)。术后1个月,2组血清IL-2水平明显升高(P<0.05),且A组显著高于B组(P<0.05);2组sIL-2R、SA水平明显降低(P<0.05),且A组显著低于B组(P<0.05)。A组出现血管危象发生率为3.92%,明显低于B组的17.65%(P<0.05)。结论股前外侧嵌合皮瓣修复口腔颌面部肿瘤根治术后缺损效果显著,可明显缩短手术时间,提高术后功能恢复,术后并发症发生率低。
- 口腔颌面部肿瘤 /
- 术后缺损 /
- 股前外侧嵌合皮瓣 /
- 串联皮瓣
Abstract: Objective To analyze and compare the clinical effect of anterolateral chimeric flaps and tandem skin flap on repair of oral and maxillofacial tumors after radical surgery. Methods Total 102 patients with oral and maxillofacial tumors after radical surgery repair in our hospital between December, 2014 and December, 2016 were selected as study objects, and were divided into group A (anterolateral chimeric flaps), group B (tandem skin flap) according to the surgery methods, with 51 cases in each group. The surgical conditions (operation time, flap production and microsurgical anastomosis time, gastric tube removal time, oral feeding time), postoperative recovery (satisfaction, shape recovery, food intake, work condition, oral closure, mouth opening, chewing function, swallowing function, bite function, language function), and serum IL-2, sIL-2R and SA levels of the two groups were compared. Results The operation time, gastric tube removal time and oral feeding time of group A were significantly lower than those of group B (P<0.05) and the production time and microscopic anastomosis time of group A were significantly higher than those of group B (P<0.05). Three months after the surgery, the satisfaction, appearance repair, work condition, oral closure, masticatory function, swallowing function and language function of group A were significantly higher than those of group B (P<0.05). One month after the operation, the serum IL-2 levels of the two groups were significantly increased, and the IL-2 level of group A was significantly higher than that of group B (P<0.05). One month after the operation, the serum sIL-2R and SA levels of the two groups were significantly increased, and the level in group A was significantly lower than that in group B (P<0.05). The incidence of vascular crisis in group A was 3.92%, which was significantly lower than that in group B (17.65%, P<0.05). Conclusion The chimeric anterolateral skin flap can repair the defect of the maxillofacial tumor after radical operation, which can significantly shorten the operation time and improve the postoperative functional recovery. The incidence of postoperative complications is low.
- Oral and maxillofacial tumors /
- Defect after radical surgery /
- Chimeric anterolateral thigh flap /
- Tandem skin flap