游离皮瓣在晚期颅底肿瘤术后组织缺损中应用效果分析

Effect and Application of Free Flap on Tissue Repair in Tissue Defects after Resection of Advanced Skull Base Tumors

目的:探讨使用游离皮瓣修复晚期颅底肿瘤术后缺损组织的效果及适应症。方法:选择2009年1月至2013年9月在我院行晚期颅底肿瘤术并且需要进行组织修复的病患74例作为研究对象。根据病患选择的修复方式分为观察组和对照组各37例。观察组采用游离皮瓣,而对照组使用钛网修复。观察两组相应指标,比较不同修复材料的修复效果。结果:观察组手术效果显效率和总有效率为40.54%(15/37)、97.30%(36/37),显著高于对照组,差异有统计学意义(P<0.05)。观察组在术中出血量、手术时间以及术后愈合时间等方面均优于对照组,差异有统计学意义(P<0.05)。观察组术后出现颅内感染、脑脊液漏和皮瓣坏死比率为8.11%(3/37)、0(0/37)和2.70%(1/37)都少于对照组,差异有统计学意义(P<0.05)。结论:采用前臂皮瓣进行晚期颅底肿瘤术后缺损组织修复效果更好,皮瓣存活率更高。比传统钛网修复引起的并发症更少,值得临床推荐使用。

Objective： To explore the effect of free skin flap on the tissue repair of tissue defects after resection of advanced skull base tumors. Methods： 74 cases of patients with advanced skull base tumor resection and the need for tissue repair from January 2009 to September 2013 in our hospital were selected as the object of study. According to the different repair methods which were selected by themselves, the patients were divided into observation group and control group with 37 cases in each. The observation group was treated with free skin flap, while the control group was treated with titanium mesh repair. Observation of the two groups＇ the corresponding index was observed beween the two groups and the effect of repair of different repair materials was compared beween the two groups. Results： The significant effective rate and total effective rate in the observation group was 40.54 % （15/37）, 97.30 % （36/37）, significantly higher than that of the control group, and the difference was statistically significant （P〈0.05）. In the observation group, the amount of bleeding, operation time and postoperative healing time was superior to the control group, the difference was statistically significant （P〈0.05）. In the observation group, the postoperative intracranial infection, cerebrospinal fluid leakage and skin flap necrosis rate was 8.11% （3/37）, 0 （0/37） and 2.70 % （1/37）, respectively, which was less than that of the control group, and the difference was statistically significant （P〈 0.05）. Conclusion： The radial forearm flap repair for the tissue defects after resection of advanced skull base tumors has better effects with higher survival rate, and fewer complications than the traditional titanium mesh repair, which is worthy of clinical recommendation and application.