颏下岛状皮瓣对N1~N2期口腔颌面部肿瘤术后缺损修复的临床研究

Clinical study of submental island flap in repairing postoperative defect of N1~N2 oral and maxillofacial tumor

目的研究颏下岛状皮瓣对N 1~N 2期口腔颌面部肿瘤术后缺损修复的应用效果。方法采用回顾性研究方法,选取2016年2月至2019年8月菏泽市立医院收治的62例N 1~N 2期口腔颌面部肿瘤患者,按照不同手术方式分为两组:对照组和观察组,每组各31例。对照组患者采用胸大肌肌皮瓣修复术,观察组患者采用颏下岛状皮瓣修复术。比较两组患者的手术皮瓣范围、手术时间、住院时间、术后皮瓣成活率及功能恢复(语言、吞咽、咀嚼功能)情况。结果观察组患者的手术皮瓣范围、手术时间、住院时间、术后皮瓣成活率及口腔功能恢复优秀率依次为(29.06±4.39)cm^2、(3.12±1.15)h、(11.03±2.51)d、96.77%(30/31)、96.77%(30/31),对照组患者的手术皮瓣范围、手术时间、住院时间、术后皮瓣成活率及口腔功能恢复优秀率依次为(43.15±5.17)cm^2、(5.17±1.43)h、(15.47±3.62)d、77.42%(24/31)、67.74%(21/31)。与对照组相比,观察组患者的手术皮瓣范围更小,手术时间、住院时间更短,术后皮瓣成活率及语言、吞咽、咀嚼功能恢复优秀率更高,差异均具有统计学意义(P<0.05)。结论颏下岛状皮瓣对N 1~N 2期口腔颌面部肿瘤术后缺损修复的应用效果显著,术后皮瓣成活率高,有利于促进患者语言、吞咽、咀嚼功能快速恢复。

Objective To study the application effect of submental island flap in repairing postoperative defect of N 1-N 2 oral and maxillofacial tumor.Methods A retrospective study was conducted,62 patients with N1~N2 stage oral and maxillofacial tumors admitted from February 2016 to August 2019 were selected,and the patients were divided into two groups according to different surgical methods,including control group and observation group,31 cases in each group.The pectoralis major myocutaneous flap was used in the control group,and the submental island flap was used in the observation group.The range,operation time,hospital stay,survival rate and functional recovery(speech,swallowing and chewing)of the flap were compared between the two groups.Results The flap operation scope,operation time,length of hospital stay,postoperative survival rate of skin flap and function recovery oral proficiency in observation group in order were(29.06±4.39)cm^2,(3.12±1.15)h,(11.03±2.51)d,96.77%(30/31),96.77%(30/31),and in the control group,the scope of flap surgery,operative time,length of hospital stay,postoperative survival rate of skin flap and function recovery oral proficiency in order were(43.15±5.17)cm^2,(5.17±1.43)h,(15.47±3.62)d,77.42%(24/31),67.74%(21/31).Compared with the control group,the range of surgical flap was smaller in the observation group,the operation time and hospital stay were shorter,and the survival rate of the flap and the recovery of speech,swallowing and chewing functions were higher in the observation group,the differences were statistically significant(P<0.05).Conclusion The application of submental island flap for repairing postoperative defect of N 1~N 2 oral and maxillofacial tumor has a significant effect.The survival rate of the flap is high,which is conducive to the rapid recovery of patients'speech,swallowing and chewing functions.