前臂皮瓣和胸大肌皮瓣修复口腔癌手术缺损的治疗效果探讨

Clinical effect of forearm flap and pectoralis major myocutaneous flap in reconstruction of defect after oral cancer surgery

目的比较分析前臂皮瓣和胸大肌皮瓣修复El腔癌手术缺损的治疗效果。方法将接受根治术后的口腔癌患者随机分为2组，每组各39例，A组和B组分别采用前臂皮瓣、胸大肌皮瓣修复口腔癌手术后颌面部缺损。观察两组修复效果，并对患者随访12个月，观察患者的并发症及对外形的满意度。结果A组前臂皮瓣成活率94．9％，B组移植皮瓣成活率为92．3％。患者随访3-12个月，平均（7．1±1．4）个月。两组患者进食、发音、吞咽、舌活动和面容外形均恢复较好，瓣膜修复处较为完整，均未见肿瘤复发。A组和B组对外形的满意率分别为87．2％，79．5％，但差异无统计学意义（x^2=0．83，P〉0．05）。结论前臂皮瓣与胸大肌皮瓣修复口腔癌术后颌面部缺损均具有较高的成功率，均适用于口腔癌手术缺损修复。

Objective To compare the effect of forearm flap and pectoralis major myocutaneous flap in oral cancer reconstruction. Meth ods Seventy-eight oral cancer patients who received radical resection were divided into two groups. Group A （n =39） and Group B （n = 39） were treated with radical forearm flap and pectoralis major myocutaneous flap, respectively. The success rate was observed, the complications and satisfaction with the appearance during 12-months follow-up were detected. Results The survival rate of flaps in group A was 94.9%, while that in group B was 92.3 %. All the patients were followed-up for 1 - 12 months, average （7.1 ± 1.4）. Patients in both groups had better recovery in eating, pronunciation, swallowing, tongue activity and shape. There was relatively complete valve re pair, and tumor recurrence was not found. The satisfactory rates with the appearance in Group A and Group B were 87.2%, 79.5%, which was not statistically significant （P 〉 0.05）. Conclusions Both forearm flap and pectoralis major myocutaneous flap can achieve a high success rate. These two kinds of flaps may be adequate for repairing tissue depots after oral cancer surgery.