小腿内侧皮瓣修复舌癌术后舌缺损12例临床分析

Reconstruction of Tongue Defects with Medial Lower Leg Flaps after Tongue Cancer Surgery:An Analysis of 12 Cases

目的探讨小腿内侧皮瓣在修复舌癌术后舌缺损中的应用效果。方法对2013年10月至2016年1月江门市中心医院收治的12例行舌颌颈联合根治术的舌癌患者,采用小腿内侧皮瓣修复舌癌术后舌缺损。对其临床资料进行回顾性分析,并采用华盛顿大学生存质量量表(university of washington quality of life questionnaire,UWQOL)对其术前术后的生存质量进行评价,包括外形、活动、疼痛、味觉、吞咽、唾液、咀嚼、语言、情绪等9项内容。结果 12例患者均顺利完成手术,移植皮瓣均成活,口腔内外创口均愈合良好,术后并发症发生率较低且经对症处理后明显改善,均于术后1~2周拆线出院。随访6个月~2年,12例患者舌功能均恢复满意。12例患者术后UW-QOL各项评分均较术前明显升高,差异有统计学意义(P<0.05)。结论小腿内侧皮瓣修复舌癌术后舌缺损效果良好,可明显改善患者舌功能和生存质量,是修复重建的一个良好选择。

Objective To explore the efficacy of medial lowe r leg flaps in th e reconstruction of tongue defects following tongue cancer surgery. Methods Clinical d a ta of 12 to ngue cancer p a-tients who underwent tongue-jaw-neck resection in Jiangmen Central Hospital between October 2013 and January 2016 were analyzed retrospectively. The quality of life was evaluated using the University of Washington Quality of Life Questionnaire（UW-QOL）,including appearance, activi_ ty, pain, taste, swallowing, saliva, chew,language and emotion. Results Al l th e 12 p a t ie n ts com-pleted operation successfully, and all transplanted flaps survived with good wound healing. Pa-tients had fewer postoperative complications, which were alleviated by symptomatic treatment. All patients were discharged from hospital 1-2 weeks after operation. The tongue function was satis-factory after 6-24 months of follow-up, and the UW-QOL scores significantly increased after oper- ation（P〈C0. 05）. Conclusion Medial lowe r leg flap t ra n sp la n ta t io n is a good choice fo r th e re co n -struction of tongue defects. It can effectively improve tongue function and quality of life in pa-tients with tongue defects following tongue cancer surgery.