颏下岛状皮瓣同期修复口腔癌术后缺损的临床应用

Clinical application of submental island flap to repair the defect during the same period after oral cancer surgery

目的观察颏下岛状皮瓣(SIF)同期修复口腔癌术后缺损的临床效果。方法回顾分析60例口腔癌术后缺损患者临床资料,将其按照治疗方法分为试验组和对照组,每组30例,试验组应用颏下岛状皮瓣进行术后缺损的修复,对照组应用前臂的桡侧皮瓣进行术后缺损的修复,对比2组的临床疗效。结果试验组临床疗效有25例为优,4例为良,其优良率达到96.7%,而对照组20例为优,6例为良,其优良率仅86.7%,2组相较,无明显差异(P>0.05)。试验组平均手术时间为(45.72±7.64)min,对照组平均手术时间为(60.14±10.68)min,2组的差异有统计学意义(P<0.05)。试验组平均术中出血量为(23.33±4.13)mL,对照组平均出血量为(27.79±5.38)mL,2组的差异有统计学意义(P<0.05);2组均未出现颈部的切口感染等相关临床并发症。结论口腔癌术后缺损应用SIF进行同期修复,不仅皮瓣的制备操作简单,而且手术用时也较短,术中出血量较少,患者取瓣伤口较隐蔽,皮瓣修复成活率高,效果显著。

Objective This study aimed to observe the clinical effects of submental island flap（SIF） for repairing oral defects after oral cancer surgery. Methods A retrospective analysis of 60 cases of postoperative oral cancer defects in patients with clinical data was performed. The experimental group and the control group were subjected to treatment（30 cases in each group）. SIF was used to repair postoperative defects in the experimental group. By contrast, the defects of the control group were treated by using the radial forearm flap after surgery. A significant difference occurred between the two groups. Results The clinical efficacy of the 25 cases in the experimental group was excellent, and 4 cases were good. Approximately 96.7% of the cases in the experimental group achieved excellent and good ratings. In the control group, 20 cases were excellent, and6 cases were good. Approximately 86.7% of the cases in the control group achieved excellent and good ratings. Thus, the two groups had no significant difference（P〈0.05）. The mean operation time in the experimental group was（45.72±7.64） min. The mean operation time in the control group was（60.14±10.68） min. Thus, a statistically significant difference（P〈0.05） was observed. The average bleeding volume was（23.33±4.13） mL, whereas the mean bleeding volume obtained from the control group was（27.79±5.38） mL. Therefore, a statistically significant difference（P〈0.05） was exhibited between the two groups. The findings indicate that the two groups were not associated with the clinical complications of cervical incision. Conclusion The application of SIF for treatment of oral cancer postoperative defects is advantageous because it is a simple and minimally invasive procedure. In addition, using SIF provides short operation time, allows less amount of intraoperative bleeding, and conceals the wound caused by flap insertion.