年龄对口腔癌游离股前外侧皮瓣修复术围手术期并发症的影响

Effects of age on the perioperative complications of free anterolateral thigh flap repair in patients with oral cancer

目的:研究患者年龄对口腔癌患者游离股前外侧皮瓣修复术围手术期并发症的影响。方法:选取2008年1月~2016年5月行口腔癌根治并行游离股前外侧皮瓣同期修复的患者550例进行回顾性分析,所有患者分为≥60岁高龄组159例和<60岁低龄组391例,收集患者围手术期并发症等临床资料,并分析年龄等对并发症发生的影响。结果:高龄组患者并发症总发生率、皮瓣修复成功率与低龄组比较(30.8%vs25.6%;96.4%vs97.0%),差异均无统计学意义(均P>0.05)。并发症全身发生率、局部发生率差异组间比较也均无统计学意义(均P>0.05)。口腔癌患者游离股前外侧皮瓣修复术后并发症发生与美国麻醉医师协会患者分级、手术时间、伴发疾病及住院时间密切有关(均P<0.05)。多因素分析结果显示,美国麻醉医师协会患者分级、手术时间、伴发疾病为口腔癌患者游离股前外侧皮瓣修复并发症发生的独立影响因素(均P<0.05),而与患者年龄无明显相关(P<0.05)。结论:高龄不会增加口腔癌游离股前外侧皮瓣修复术围手术期并发症的发生;控制手术时间可有效减少围手术期并发症发生。

Objective： ：To study the effects of age on the perioperative complications of free anterolateral thigh flap repair in patients with oral cancer. Methods ： The clinical characteristics of 550 oral cancer patients who underwent free an- terolateral thigh f/ap repair operation from Jan 2008 to May 2016 were retrospectively analyzed. All patients were divided into two groups,including young group （ 〈 60 years old,391 cases） and old group （ ≥ 60 years old, 159 cases）. To compare and analyze the perioperative complications, and find out the affecting factors, such as age of patients. Results：The total rate of perioperative complications in old group and young group were 30. 8% and 25.6% , the overall rate of flap repair in old group and young group were 96. 4% and 97.0% , respectively. The differences between two groups were insignificant （ both P 〉 0. 05 ）. The differences between two groups in rates of whole and local complication were also insignificant（ both P 〉 0. 05 ）. The perioperative complications of free anterolateral thigh flap repair in patients with oral cancer were correlated with Ameri- can Society of Anesthesiologists （ASA） status, operation time, hospital stay and comorbidity （ all P 〈 0. 05 ）. Multivariate cox regression analyses revealed that ASA status, operation time and comorbidity were independent factors affecting perioperative complications of free anterolateral thigh flap repair in patients with oral cancer（ all P 〈 0. 05 ） , however, age was not an independent factor for the complications of patients （P 〉 0. 05 ）. Conclusion：The old age doesn＇ t increase the rate of periopera- tire complications of free anterolateral thigh flap repair in patients with oral cancer. In addition, controlling operation time is very important in reducing the perioperative complications.