颌面部组织缺损游离组织瓣移植术后红蓝光照射对受区并发症及患者生活质量的影响

The Effect of Red and Blue Light Irradiation on the Complications and Quality of Life of Patients with Maxillofacial Tissue Defect after Free Flap Transplantation

目的:探讨颌面部组织缺损后游离组织瓣修复重建受区并发症的预防与护理。方法:入组病例116例,均来自笔者科室2017年12月-2018年12月收治的颌面肿瘤切除+游离组织瓣修复重建患者,采用随机数字表法分为研究组和对照组,每组58例。两组患者均采用颌面肿瘤切除+游离组织瓣修复治疗,研究组患者除常规治疗外每日使用光子治疗仪照射受区组织瓣。观察两组患者住院期间受区伤口并发症发生情况,出院时整体生活质量及术后6个月满意度,并进行对比评估。结果:颌面部组织缺损患者采用游离组织瓣修复重建治疗后,游离组织瓣存活率研究组为96.55%,对照组为94.83%,两组比较无显著性差异(P>0.05);住院期间受区伤口(游离组织瓣修复区域)并发症发生率研究组为8.62%,低于对照组的22.41%,差异有统计学意义(P<0.05);出院时两组患者GQOL-74生活质量量表评分比较,各维度得分及总分研究组均高于对照组,差异有统计学意义(P<0.05);术后6个月复诊,研究组患者(82.75%)术后外形满意度高于对照组(62.07%),差异有统计学意义(P<0.05)。结论:颌面部组织缺损采用游离组织瓣修复重建的患者,治疗期间使用光子治疗仪进行红蓝光照射,能够降低游离组织瓣修复区域伤口并发症发生率,还可提高患者的整体生活质量及满意度。

Objective To explore the prevention and nursing of complications of free tissue fl ap in reconstruction of maxillofacial tissue defects.Methods A total of 116 patients were enrolled,who were treated by our department from December 2017 to December 2018.The patients were randomly divided into study group and control group,58 cases in each group.Both groups were treated with maxillofacial tumor resection and free tissue fl ap repair.In the study group,except for routine treatment,the tissue fl ap in the receiving area was irradiated daily with photon therapy instrument.The incidence of wound complications,the overall quality of life at the time of discharge and the satisfaction of 6 months after operation were observed and compared between the two groups.Results The survival rate of free tissue fl ap was 96.55%in the study group and 94.83%in the control group,and there was no signifi cant difference between the two groups(P>0.05).The incidence of complications of wounds(free tissue fl ap repair area)in the study group was 8.62%,lower than 22.41%in the control group,and the difference was statistically signifi cant(P<0.05).At the time of discharge,the scores of GQOL-74 quality of life scale of the two groups were higher than those of the control group in all dimensions and total scores,with statistical signifi cance(P<0.05).After 6 months of follow-up,the patients in the study group(82.75%)were more satisfi ed with their appearance than those in the control group(62.07%),with statistical significance(P<0.05).Conclusion In the patients with maxillofacial tissue defect repaired and reconstructed with free tissue fl ap,red and blue light irradiation with photon therapy instrument can reduce the incidence of wound complications in the area of free tissue fl ap repair,and improve the overall quality of life and satisfaction of patients.