口腔颌面部组织缺损应用游离股前外侧皮瓣修复的效果分析

Effect analysis of free anterolateral thigh flap in repairing oral and maxillofacial tissue defects

目的 探讨口腔颌面部组织缺损应用游离股前外侧皮瓣修复的效果.方法 收集本院2013年1月至2015年6月入院的56例口腔颌面部组织缺损患者,采用随机数字法分为两组,A组患者采用游离股前外侧皮瓣修复,B组患者采用前臂皮瓣修复,比较两组患者治疗前后语言清晰度、吞咽功能、生活质量与治疗后供区情况.结果 两组患者治疗后语言清晰度评分[（3.16±0.79）vs.（3.12±0.83）]与吞咽功能评分[（2.65±0.56） vs.（2.59±0.61）]组间比较差异无统计学意义（P＞0.05）;两组患者治疗后疼痛、外貌、娱乐、活力、吞咽、咀嚼、语言、肩功能、味觉、唾液、情绪、焦虑及总分组间比较差异无统计学意义（P＞0.05）;A组患者疤痕组织增生（0）与永久性功能缺陷发生率（0）明显低于B组（25.00％,17.86％）,差异有统计学意义（P＜0.05）;A组患者瘙痒（10.71％）、色素沉着（53.57％）与暂时性功能缺陷发生率（7.14％）显著性低于B组（50.00％,96.43％,42.86％）,差异有统计学意义（P＜0.01）.结论 口腔颌面部组织缺损应用游离股前外侧皮瓣修复的效果显著,供区状态良好,具有借鉴性.

Objective To investigate the effect of free anterolateral thigh flap in repairing oral and maxillofacial tissue defects.Methods 56 cases of oral and maxillofacial tissue defects admitted in our hospital from January 2013 to June 2015 were randomly divided into two groups,patients of group A underwent free anterolateral thigh flap repairment,while patients of group B underwent forearm flap repairment.Compared speech intelligibility,swallowing function,quality of life before and after treatment,the situation of donor site after treatment of two groups.Results There were no statistically significant differences in the scores of speech intelligibility,swallowing function between two groups after treatment [（3.16±0.79） vs.（3.12±0.83）,（2.65±0.56）vs.（2.59±0.61）;P〉0.05].There were no statistically significant differences in the scores of pain,appearance,entertainment,energy,swallowing,chewing,language,shoulder function,taste,saliva,mood,anxiety,and total score between two groups after treatment （P〉0.05）.The incidence of scar tissue hyperplasia,permanent functional defects of group A were significantly lower than those of group B （0% vs.25%,0% vs.17.86%）,with statistically significant differences （P〈0.05）.The incidence of pruritus,pigmentation,and transient dysfunction of group A were significantly lower than those of group B （10.71% vs.50%,53.57% vs.96.43%,7.14% vs.42.86%）,with statistically significant differences （P〈0.01）.Conclusion Free anterolateral thigh flap has significant effect in repairing oral and maxillofacial tissue defects,with good condition of donor site,with reference.