口腔癌根治术同期颌面部组织缺损游离组织瓣移植修复术中静脉超回流技术的应用观察

Observation on the Application of Venous Super-flow Technique in the Repair of Maxillofacial Tissue Defect with Free Tissue Flap During Radical Resection of Oral Cancer

目的 探讨口腔癌根治术同期颌面部组织缺损游离组织瓣移植修复术中静脉超回流技术的应用效果。方法 回顾性分析85例口腔癌患者的临床资料,所有患者全部施行手术治疗,于此同时运用游离组织瓣进行修复,运用静脉超回流技术于供受区制作并吻合两套静脉回流系统,形成超回流模式的43例患者为观察组,而仅制备和吻合一套静脉回流系统的42例患者为对照组。观察到术后3个月,对比患者的血管吻合时间、组织瓣危象率与坏死率、组织瓣肿胀程度及面容美观满意度。结果 观察组血管吻合时间[(34.23±2.46)min]长于对照组[(21.39±1.89)min],组织瓣危象率与坏死率[6.98%(3/43)、4.65%(2/43)]均低于对照组[23.81%(10/42)、21.43%(9/42)],肿胀程度轻于对照组,面容美观满意度[93.02%(40/43)]高于对照组[76.19%(32/42)],有统计学差异(P<0.05)。结论 口腔癌根治术同时期行颌面部组织缺损游离组织瓣移植修复术中运用静脉超回流技术虽然多吻合一根回流静脉会延长血管吻合时长,但能够降低组织瓣危象与坏死率,并可有效缓解组织瓣肿胀水平,提高面容美观满意度,临床应用价值较高,值得进行大力推广。

Objective To investigate the application effect of venous hyperreflux technique in the repair of maxillofacial tissue defect with free tissue flap during radical resection of oral cancer.Methods The clinical data of 85 patients with oral cancer were retrospectively analyzed.All the patients were treated with surgery.At the same time,free tissue flaps were used for repair.Two sets of venous reflux systems were made and anastomosed in the donor and recipient areas using the venous reflux technology.43 patients with the formation of the reflux pattern were the observation group,while 42 patients with only one set of venous reflux system were the control group,and 3 months after the operation were observed.The time of vascular anastomosis,the rate of tissue valve crisis and necrosis,the degree of tissue valve swelling and the satisfaction of facial beauty were compared.Results The time of vascular anastomosis in the observation group[(34.23±2.46)min]was longer than that in the control group[(21.39±1.89)min],the rate of tissue valve crisis and necrosis[6.98%(3/43),4.65%(2/43)]were lower than that in the control group[23.81%(10/42),21.43%(9/42)],the degree of swelling was lighter than that in the control group,and the satisfaction of facial beauty[93.02%(40/43)]was higher than that in the control group[76.19%(32/42)],with statistical difference(P<0.05).Conclusion The use of venous super-reflux technique in the free tissue flap transplantation of maxillofacial tissue defects at the same time of radical surgery for oral cancer can prolong the time of vascular anastomosis,but it can reduce the rate of tissue flap crisis and necrosis,effectively alleviate the level of tissue flap swelling,improve the satisfaction of facial beauty,and has high clinical application value,which is worth vigorously promoting.