前臂皮瓣及颈横血管蒂斜方肌肌皮瓣在口腔癌切除术后缺损修复中的应用比较

Comparison of the clinical outcome of defect reconstruction after oral cancer resection using forearm flap and trapezius myocutaneous flap pedicled with the transverse cervical artery

目的比较游离前臂皮瓣与斜方肌岛状肌皮瓣修复口腔癌手术切除后缺损的临床效果及应用价值。方法2014年5月至2017年5月，56例患者接受口腔癌根治手术并以前臂皮瓣（29例）或以颈横血管为蒂的上斜方肌岛状肌皮瓣（27例）修复，应用t检验比较2组患者术后恢复时间、手术成功率及术后生存质量。结果前臂皮瓣组和斜方肌肌皮瓣组患者术后恢复时间分别为（9.4±2.7） d和（9.3±2.6） d （P＝0.489），修复成功率分别为96.6%（28/29）和96.3%（26/27）（P＝0.920），术后生存质量评分分别为（576.3±76.2）分和（568.4±79.3）分（P＝0.471）, 2组各指标分别比较，差异均无统计学意义（P〉0.05）。结论应用游离前臂皮瓣或以颈横血管为蒂的斜方肌岛状肌皮瓣修复口腔癌手术切除后缺损，均可获得满意的功能和较好的临床效果，后者对供区影响小，可作为首选方法。

ObjectiveTo compare and analyze the effects of forearm flap and superior trapezius myocutaneous flap in repairing oral cancer defects.Methods56 cases of defect repair after oral cancer radical surgery were treated with the forearm flap （29 cases） and superior trapezius myocutaneous flap （27 cases）. The success rate, postoperative quality of life and postoperative recovery time of the two groups were compared. The t-test was used for statistical analysis.ResultsThe success rate of forearm flap group was 96.6%（28/29） compared to 96.3%（26/27） in the trapezius myocutaneous flap group （P=0.920）. The postoperative recovery time was （9.4±2.7） d （forearm flap group） and （9.3±2.6） d （trapezius myocutaneous flap group）, respectively （P=0.489）. The score of postoperative quality of life was 576.3±76.2 （forearm flap group） and 568.4±79.3 （trapezius myocutaneous flap group）, respectively （P=0.471）. There was no significant difference in all comparisons （P〉0.05）.ConclusionsThe free forearm flap and the superior trapezius myocutaneous flap pedicled with the transverse cervical artery can be used to repair the oral cancer, and satisfactory function and ideal clinical effect can be achieved. Both two kinds of flaps have high success rate and good clinical practical value. The latter has little influence on the donor site, and can be used as the first choice.