口腔颌面部恶性肿瘤术后缺损Ⅰ期修复与重建的临床观察

Clinical observation on oral and maxillofacial malignant postoperative defectⅠrepair and reconstruction

目的 探究不同修复方法对口腔颌面部恶性肿瘤术后缺损Ⅰ期修复和重建的临床效果.方法 选取我院2005年5月～2011年5月165例口腔颌面部恶性肿瘤切除后缺损的患者,分别采用胸大肌肌皮瓣、游离前臂皮瓣、游离股前外侧皮瓣三种方法进行修复重建,每组55例,观察修复与重建后的效果及并发症情况.结果 游离前臂皮瓣和游离股前外侧皮瓣方法进行修复的两组患者皮瓣成活和外形满意情况明显优于胸大肌肌皮瓣组,差异有统计学意义（P＜0.05）.游离股前外侧皮瓣修复患者并发感染情况明显低于胸大肌肌皮瓣组患者,差异有统计学意义（P＜0.05）.胸大肌肌皮瓣患者出血情况明显少于游离前臂皮瓣,差异有统计学意义（P＜0.05）.结论 不同修复方法对口腔颌面部恶性肿瘤术后缺损Ⅰ期修复与重建效果和并发症存在一定程度的差异.

Objective To investigate the clinical effects of different repair methods on the postoperative defect of oral and maxillofacial malignancies Phase Ⅰ of the restoration and reconstruction of.Mothods 165 cases of oral and maxillofacial defects after malignant tumor resection were used the pectoralis major muscle flap,free forearm flap,free anterolateral thigh flap repair and reconstruction.The effects and complications after the repair and reconstruction were observed.Results Free forearm flap and free shares thigh flap method to repair in two groups of patients with flap and overall satisfaction was significantly superior to the pectoralis major muscle flap group.The difference was statistically significant（P＜0.05）.Free anterolateral thigh flap in patients with concurrent infection was significantly lower than the pectoralis major muscle flap patients （P＜0.05）.Pectoralis major muscle flap in patients with bleeding was significantly less than the free radial forearm flap （P＜0.05）. Conclusion There is a certain degree of difference in different repair methods of oral and maxillofacial malignancies postoperative defects phase Ⅰ repair and reconstruction effects and complications.