头颈肿瘤游离皮瓣修复术后皮瓣坏死及皮瓣相关并发症影响因素分析

Factors affecting flap neurosis and other postoperative flap-related complications after free-flap reconstruction of head and neck tumors

目的分析皮瓣坏死及术后出现皮瓣相关并发症的影响因素。方法回顾性分析因头颈肿瘤行游离皮瓣修复患者的年龄、性别、手术时长、吸烟、酗酒、高血压、糖尿病、术前放疗、血管吻合方式等对皮瓣坏死及皮瓣相关术后并发症的影响作用。结果年龄、性别、手术时长、吸烟、酗酒、术前放疗、血管吻合方式不是头颈肿瘤患者游离皮瓣修复后皮瓣坏死及发生皮瓣相关术后并发症的危险因素;糖尿病是头颈肿瘤患者游离皮瓣修复后皮瓣坏死的危险因素(P=0.006),高血压(P=0.040)、糖尿病(P=0.024)是出现皮瓣相关术后并发症的独立危险因素。结论在有游离皮瓣修复指征的头颈肿瘤但伴随有糖尿病、高血压疾病的患者中,经过全身情况评估后个体化选择修复方式。

Objective This study aimed to explore the factors affecting flap neurosis and other postoperative flap-related complications.Methods Patients who underwent free-flap reconstruction of head and neck tumors were examined.Factors such as of age,sex,operation duration,smoking,alcohol consumption,hypertension,diabetes,preoperative radiotherapy,vascular anastomosis skill on flap neurosis,and flap-related complications were analyzed.Results We observed that age,sex,operation duration,smoking,alcohol consumption,preoperative radiotherapy,and vascular anastomosis skill were not risk factors for flap neurosis and flap-related complications after free flap reconstruction in patients with head and neck tumors;Diabetes was observed to be a risk factor for flap failure after free-flap reconstruction in patients with head and neck tumors(P=0.006),whereas hypertension(P=0.040)and diabetes(P=0.024)were independent risk factors for flap-related complications.Conclusion Individualized reconstruction methods should be used in patients with head and neck tumors who are suffering from diabetes and are candidates for free-flap reconstruction.