不同皮瓣修复口腔癌手术缺损的疗效及美容度的影响

Therapeutic effects and cosmetic results of different skin flaps in defect repair after oral cancer operation

目的:探究口腔癌手术缺损采用不同皮瓣修复对其疗效以及美容度影响。方法:回顾性分析2017年7月~2020年1月我院行口腔癌手术缺损皮瓣修复100例患者相关资料,依据皮瓣修复方式将前臂以及股前外侧皮瓣修复患者分别纳入前臂组(n=42)与股前外侧组(n=58)。比较两组患者围手术期相关指标,皮瓣成活情况,术后口腔功能情况,术后美观度,术后并发症情况。结果:前臂皮瓣组与股前外侧组患者皮瓣制作时间、住院时间差异无统计学意义;前臂皮瓣组手术时间、皮瓣面积显著低于股前外侧组(P<0.05)。前臂组与股前外侧组患者皮瓣成活率分别为97.62%(41/42)和93.10%(54/58),差异无统计学意义。前臂皮瓣组与股前外侧组术后口腔功能差异无统计学意义;厚度、瘙痒或疼痛程度、硬度、平整度、颜色等患者瘢痕评分及厚度、顺应度、充血程度、柔软度、色泽等观察者瘢痕评分评分上差异均无统计学意义。股前外侧组术后并发症显著低于前臂组(6.90%vs.23.80%),供皮区感染率显著高于前臂组(17.24%vs.2.38%)(P<0.05)。结论:口腔癌手术缺损修复采用前臂皮瓣与股前外侧皮瓣在患者术后口腔功能与美容度上效果相当;前臂皮瓣手术时间较短、供皮区感染率较低,而股前外侧组术后并发症少,安全性高。

Objective:To explore the therapeutic effects and cosmetic results of different skin flaps in defect repair after oral cancer operation.Methods:The relevant data of 100 patients who underwent defect repair after oral cancer operation in the hospital from July 2017 to January 2020 were retrospectively analyzed.According to the skin flap used for repair, patients treated with forearm flap and anterolateral thigh flap were included in the forearm group(n=42)and the anterolateral thigh group(n=58),respectively.Related perioperative indicators, survival flap, postoperative oral function, postoperative cosmetic results and postoperative complications were compared between the two groups.Results:There were no statistically significant differences in flap preparation time and hospital stay between the two groups(P>0.05).The operation time and flap area of the forearm group were significantly shorter/smaller than those of the anterolateral thigh group(P<0.05).The flap survival rates of the forearm group and the anterolateral thigh group were 97.62%(41/42)and 93.10%(54/58)(P>0.05).There were no significant differences between the two groups in oral function, thickness, itching or pain degree, hardness, flatness, color and other patient scar scores, thickness, compliance, hyperemia degree, softness, color and other observer’s scar scores(P>0.05).The incidence of postoperative complications in the anterolateral thigh group was significantly lower than that in the forearm group(6.90%vs.23.80%),and the infection rate in the donor area was significantly higher than the forearm group(17.24%vs.2.38%)(P<0.05).Conclusion:Forearm flaps and anterolateral thigh flaps can achieve similar effects in defect repair after oral cancer operation in terms of oral function and cosmetic results.However, the duration of forearm flap repair is shorter and the infection rate in the donor area is lower.Meanwhile, repair using anterolateral thigh flap is with few complications and high safety.