薄型股前外侧皮瓣与前臂皮瓣修复老年口腔癌切除术后缺损的效果比较

Comparison of reconstruction of defect in the elderly after oral cancer resection using thin anterolateral thigh flap with using forearm flap

目的:探讨薄型股前外侧皮瓣与前臂皮瓣2种方式修补老年口腔癌患者切除术后缺损的效果。方法:选取2017年1月—2019年10月期间在我院进行诊治的老年口腔癌患者54例,所有患者均实施口腔癌切除术,其中用前臂皮瓣进行缺损修补的24例为前臂组,用薄型股前外侧皮瓣进行缺损修补的30例为股前外侧组,用华盛顿大学生命质量问卷(the University of Washington quality of life,UW-QOL)、口腔健康影响程度量表(the 14-item oral health impact profile questionnaires,OHIP-14)对患者进行主观评价,对比2组量表评分及手术恢复情况。结果:前臂组中,皮瓣存活的例数为23例,股前外侧组为29例,2组患者皮瓣存活例数、血管危象例数、坏死例数、恢复时间比较,差异均无统计学意义(P>0.05)。前臂组色素沉着发生率明显高于股前外侧组,差异具有统计学意义(P<0.05),而在瘢痕增生发生率方面,前臂组也明显高于股前外侧组,差异具有统计学意义(P<0.05)。2组UW-QOL问卷及OHIP-14量表评分比较,差异无统计学意义(P>0.05)。结论:对于老年口腔癌切除术后缺损的修补,采用薄型股前外侧皮瓣相比于前臂皮瓣,缺损区恢复情况及术后量表评分无明显差别,但该方式可以减少皮瓣供区的相关并发症的发生。

Objective:To investigate and compare the efficacy between thin anterolateral thigh flap and forearm flap in repairing defect after oral cancer resection with elderly patients.Methods:A total of 54 elderly patients with oral cancer who were treated in our hospital from January 2017 to October 2019 were enrolled.All patients had accepted ablative oral resection.24 cases were repaired with thin anterolateral thigh flaps,which was the anterolateral thigh group,while the other 30 cases who were repaired with the forearm flap were the forearm group.The comparison of outcomes between groups were prepared in accordance with guidelines from The University of Washington quality of life(UW-QOL)and the 14-item oral health impact profile questionnaires(OHIP-14).Results:There were 23 patients in forearm group and 29 patients in anterolateral thigh group completed the reconstruction.There were no significant differences in the number of survivors,vascular crisis and necrosis,recovery time between the two groups(P>0.05).The incidence of pigmentation of the forearm group was higher than that of the anterolateral thigh group,and the difference was statistically significant(P<0.05).The incidence of scar hyperplasia was significantly higher in the forearm group than that in the anterolateral thigh group,and the difference was statistically significant(P<0.05).There were no significant differences between the two groups in the UW-QOL scale and the OHIP-14 scale(P>0.05).Conclusion:On repairing defect in elderly patients after oral cancer resection,using thin anterolateral thigh flap showed no significant difference in the recovery of the defect area and the postoperative scale score,compared with using forearm flap,but can reduce the relative concurrency of the flap donor area.