不同游离组织瓣在耳鼻喉头颈肿瘤缺损与修复中的应用价值

Donor site choice for free flaps in head and neck reconstruction after tumor surgry

目的探讨不同游离组织瓣在耳鼻喉头颈肿瘤缺损与修复中的应用价值。方法选取2009年4月～2012年4月本院收治的40例耳鼻喉头颈肿瘤切除及修复患者,根据修复方法分为观察组与对照组,观察组20例,对照组20例;观察组应用不同游离组织瓣进行修复,对照组应用胸大肌肌皮瓣。比较两组患者的术后成活率、术后感染率及生活质量。结果观察组成活率为95.00%,对照组为80.00%,差异无统计学意义(χ2=2.057,P>0.05)。观察组患者整体QL、功能总分、症状总分得分为(68.2±10.3)、(70.5±12.6)、(35.5±8.9)分,均高于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为15.00%(3/20),高于对照组35.00%(7/20),差异有统计学意义(χ2=10.417,P<0.05)。结论选取恰当游离组织瓣修复耳鼻喉头颈肿瘤缺损,可以提高术后成活率,降低术后感染率,提高患者术后生活质量,对于患者术后功能恢复具有重要的临床应用价值。

Objective To implore the application of various self-tissues in repairment of postoperative injury of ENT- head-neck tumor. Methods Forty cases with ENT-head-neck tumor underwent immediate reconstruction with appli- cation of various self-tissues according to the sites and shape of the defects and returned for evaluation. Results The observe of survival rate was 95%, 80% in the control group, the difference was not statistically significant （x^2=2.057, P 〉 0.05）. Patients in the observation group, the overall QL function score, symptom scores were 68.2 ± 10.3, 70.5±12.6, 35.5±8.9, were higher than those in the control group, the difference was statistically significant （P 〈 0.05）. Patients in the observation group the incidence of postoperative complications was 15% （3/20）, higher than 35% in the control group （7/20）, the difference was statistically significant （x^2=10.417, P 〈 0.05）. Conclusion Selecting the appropriate free flap has important clinical value for patients undergoing functional recovery of otolaryngology-head and neck head and neck cancer defect.