带蒂颊脂垫组织瓣移植修复颊黏膜缺损的应用及其愈合效果

Application of pedicled buccal fat tissue flap for buccal mucosa defect repair and its healing effect

目的探讨带蒂颊脂垫组织瓣移植在颊黏膜缺损修复中的应用及愈合效果。方法选择2015年8月~2017年8月冀中能源峰峰集团总医院收治的颊黏膜缺损患者90例,根据修复方案分为对照组(45例)和观察组(45例)。对照组采用舌瓣修复手术治疗,观察组采用自体带蒂颊脂垫组织瓣移植治疗,两组均进行3个月修复,修复完毕后对修复效果进行评估。记录并统计两组修复前和修复后1、2、3个月缺损创面直径;记录并统计两组修复后3个月组织瓣坏死、开口受限、舌运动障碍及水肿发生率,比较两组修复效果及对愈合效果的影响。结果观察组与对照组修复前缺损创面直径比较差异无统计学意义(P>0.05);观察组与对照组修复后1、2、3个月缺损创面均小于修复前(P<0.05);观察组修复后1、2、3个月缺损创面均小于对照组(P<0.05)。观察组带蒂颊脂垫组织瓣移植修复后3个月组织瓣坏死、开口受限、舌运动障碍及水肿发生率均低于对照组(P<0.05)。结论带蒂颊脂垫组织瓣移植用于颊黏膜缺损修复中效果理想,能缩短缺损创面直径,术后并发症发生率较低,值得推广应用。

Objective To investigate the application of pedicled buccal fat tissue flap in the repair of buccal mucosal defects and its healing effect. Methods A total of 90 patients with buccal mucosa defects treated in the General Hospitial of Jizhong Energy Fengfeng Group from August 2015 to August 2017 were selected and divided into control group（n = 45） and observation group（n = 45） according to the repair protocol. The control group was treated with tongue flap repair surgery, and the observation group was treated with autologous pedicle buccal fat pad tissue flap. Both groups were repaired for 3 months and the repair effect was evaluated after the repair. The diameter of wounds in the two groups before and 1, 2 months and 3 months after the repair and tissue flap necrosis, opening restriction, dyskinesia and edema incidence at three months after repair were recorded and counted, and the repair effect of two groups and the effect on the healing effect were compared. Results There was no significant difference in the diameter of wounds between the observation group and the control group before repair（P〈0.05）. The defect wounds in the observation group and the control group at 1, 2 months and 3 months after the repair were smaller than those before the repair（P〈0.05）; the defect wounds in the observation group at 1, 2 months, and 3 months after repair were all smaller than those in the control group（P〈0.05）. Three months after the repair, the incidences of necrosis, opening limitation,dyskinesia and edema were all lower than those in the control group（P〈0.05）. Conclusion The pedicled buccal pad flap is ideal for the repair of buccal mucosal defects. It can shorten the diameter of the wound and the incidence of postoperative complications, which is worthy of clinical application.