影响游离皮瓣移植修复口腔颌面部肿瘤术后皮瓣失活的因素分析

Analysis of the factors influencing the flap deactivation of oral maxillofacial tumor after free flap transplantation

目的:分析游离皮瓣移植修复口腔颌面部肿瘤术后皮瓣失活的影响因素。方法:选择2014年10月至2019年10月在我院接受游离皮瓣移植修复治疗的口腔颌面部肿瘤术后缺损患者78例进行回顾性分析。根据皮瓣存活情况将患者分为2组,其中出现皮瓣失活的为观察组,皮瓣存活的为对照组。收集两组患者临床及实验室相关指标,计量资料组间比较行独立样本t检验,计数资料采用χ2检验,多因素分析行logistic回归分析。结果:78例患者中共11例(14.10%)出现皮瓣失活,其中10例(90.91%)为不完全失活。单因素分析结果显示糖尿病患病率、淋巴结转移率、口腔感染率、白蛋白、总蛋白及纤维蛋白原水平,两组比较差异有统计学意义(均P<0.05)。多因素分析结果显示:糖尿病、口腔感染、纤维蛋白原升高为术后皮瓣失活的危险因素(均P<0.05)。结论:游离皮瓣移植修复口腔颌面部肿瘤术后缺损皮瓣失活主要与患者糖尿病、口腔感染及纤维蛋白原水平有关。

Objective:To analyze the factors that affect the flap inactivation of oral and maxillofacial tumor with free flap transplantation.Methods:The data of 78 patients with oral and maxillofacial tumors who underwent repair with free flap transplantation in our hospital from October 2014 to October 2019 was retrospectively analyzed.The patients were divided into the flap inactivation group and the flap survival group.Measurement data was compared in the two group by independent sample t test,count data were analyzed byχ2 test,and multivariate analysis was performed by logistic regression analysis.Results:In 78 patients,11(14.10%)had flap deactivation,of which 10(90.91%)had partial deactivation.The results of univariate analysis showed that there were significant differences between the two groups in the incidence of diabetes mellitus,lymph node metastasis,oral infection and the level of albumin,total protein and fibrinogen(P s<0.05).Multivariate analysis showed that diabetes,oral infection,and elevated fibrinogen were the risk factors for flap inactivation(P s<0.05).Conclusion:The factors influencing flap inactivation with free flap transplantation for the reconstruction of oral and maxillofacial tumor include diabetes mellitus,oral infection and fibrinogen level.