游离皮瓣在颌面部组织缺损修复中的临床效果

目的比较游离股前外侧皮瓣与游离前臂皮瓣对于恶性肿瘤切除术后颌面部组织缺损修复中的临床效果。方法收集行口咽部恶性肿瘤扩大切除及游离皮瓣修复的患者87例，其中46例采用前臂皮瓣修复（A组），41例采用股前外侧皮瓣修复者（B组）；比较两组患者术前资料及术后的皮瓣存活率、言语及吞咽功能、供皮区并发症。结果两组皮瓣存活率差异无统计学意义（P〉O．05）。B组暂时性功能障碍比例为5％（2／41），显著低于A组。B组患者较A组患者满意度高。结论股前外侧皮瓣较前臂皮瓣能更好地降低术后供区功能障碍、感觉麻木及异常、瘢痕，患者更易接受。

Objective To compare intraoperative, postoperative and functional results of the radial forearm fasciocutaneous flap with the thinned anterolateral thigh cutaneous flap reconstruction for oral and orpharyngeal reconstruction. Methods 87 reconstructions were performed in patients submitted to surgery for oral and oropharyngeal carcinoma using, a radial forearm fasciocutaneous flap （ A group, n=46 ） and anterolateral thigh cutaneous flap group （ B group, n=41 ） . Compare duration of operation, quality of life, survival rate, surgical complications, and speech and swallowing function of the two group. Result Functional results, at donor site, were less successful in the group A, with permanent forearm movement impairment in 15% （ 7/46 ） of cases; in the group B, only transitory gait impairment occurred in 5% （ 2/41 ） of patients. Patient satisfaction survey results showed that patients in the group B were more satisfied than group A. Conclusion Anterolateral thigh cutaneous flap is better than radial forearm fasciocutaneous flap for oral and orpharyngeal reconstruction.