游离腹壁下动脉穿支皮瓣在头颈部恶性肿瘤切除术后创面修复中的应用

Application of Free Deep Inferior Epigastric Perforator Flap in Wound Repair after Resection of Head and Neck Malignant Tumor

目的:探讨游离腹壁下动脉穿支皮瓣在头颈部恶性肿瘤切除术后创面修复中的应用价值。方法:采用回顾性研究方法,选取2014年1月-2019年4月在笔者医院治疗的头颈部恶性肿瘤患者82例,根据治疗方案分为观察组(n=42)和对照组(n=40),观察组给予游离腹壁下动脉穿支皮瓣治疗,对照组给予游离腹直肌皮瓣修复。比较两组皮瓣面积、皮瓣制备时间、皮瓣成活、生活质量及并发症发生情况。结果:观察组皮瓣制备时间为(78.12±9.55)min,明显高于对照组的(53.32±8.03)min,差异有统计学意义(P<0.05)。观察组皮瓣存活率为97.62%,高于对照组的90.00%,但差异无统计学意义(P>0.05)。观察组SF-36量表中社会功能、情感角色评分分别为(74.41±6.06)分和(75.51±5.78)分,明显高于对照组的(68.89±5.52)分和(70.03±6.03)分,差异有统计学意义(P<0.05);两组生理功能、躯体角色、躯体疼痛、总体健康、活力和心理健康评分比较差异无统计学意义(P>0.05)。两组并发症总发生率比较差异无统计学意义(P>0.05)。结论:游离腹壁下动脉穿支皮瓣在头颈部恶性肿瘤切除后创面修复中有较好的应用价值,值得临床推广。

Objective To explore the application value of free deep inferior epigastric perforator flap for repairing the wound after resection of head and neck malignant tumor.Methods Retrospective study method,82 patients with head and neck cancer treated in our hospital from January 2014 to April 2019 were divided into the observation group(n=42)and control group(n=40)according to the treatment plan,the observation group was treated with free deep inferior epigastric perforator flap,the control group was treated with free rectus abdominis myocutaneous flap.The area,preparation time,survival,quality of life and complications of the two groups were compared.Results The time of flap preparation in the observation group was(78.12±9.55)min,which was significantly higher than that in the control group(53.32±8.03)min,the difference was statistically significant(P<0.05).The flap survival rate of the observation group was 97.62%,which was higher than that of the control group(90.00%),but there was no significant difference between the two groups(P>0.05).The scores of social function and emotional role of SF-36 in the observation group were(74.41±6.06)and(75.51±5.78),which were significantly higher than those in the control group[(68.89±5.52)and(70.03±6.03),P<0.05].There was no significant difference in physical function,physical role,physical pain,overall health,vitality and mental health between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Free deep inferior epigastric perforator flap has a good application value for repairing the wound after resection of head and neck malignant tumor,which is worth clinical use.