薄型股前外侧皮瓣修复对舌癌患者术后软组织缺损的修复效果

Repair effect of thin anterolateral thigh flap on postoperative soft tissue defects in tongue cancer patients

目的探讨薄型股前外侧皮瓣修复(ALTF)对舌癌患者术后软组织缺损的修复效果。方法依据术后软组织重建方法的不同将110例舌癌患者分为游离前臂桡侧皮瓣(RFFF)组和ALTF组,每组55例,RFFF组患者术后给予RFFF软组织重建,ALTF组患者术后给予薄型ALTF软组织重建,术后均随访12个月。比较两组患者的围手术期指标、生活质量[健康调查简表(SF-36)]、术后并发症发生情况及满意度。结果ALTF组患者皮瓣面积明显大于RFFF组,手术时间、恢复或愈合时间均明显短于RFFF组,差异均有统计学意义(P﹤0.01)。随访12个月,两组患者SF-36量表各维度评分均高于本组治疗前,ALTF组患者SF-36量表各维度评分均高于RFFF组,差异均有统计学意义(P﹤0.05)。随访12个月,ALTF组患者术后并发症总发生率为1.82%,低于RFFF组患者的14.55%,差异有统计学意义(P﹤0.05);ALTF组患者的满意度为98.18%,明显高于RFFF组患者的76.36%,差异有统计学意义(P﹤0.01)。结论薄型ALTF应用于舌癌患者术后软组织缺损的修复中效果优于RFFF,能够改善患者的生活质量,降低术后皮瓣血运不良等并发症的发生率,提高患者满意度。

Objective To investigate the repair effect of thin anterolateral thigh flap(ALTF)on postoperative soft tissue defects in tongue cancer patients.Method A total of 110 patients with tongue cancer were divided into radial forearm free flap(RFFF)group and ALTF group according to the different methods of postoperative soft tissue reconstruction,with 55 cases in each group.Patients in the RFFF group were given RFFF soft tissue defects after the operation,and patients in the ALTF group were given thin ALTF soft tissue defects after the operation.Both were followed up for 12 months after the operation.The perioperative indicators,quality of life[the MOS 36-item short form health survey(SF-36)],postoperative complications,and satisfaction were compared between the two groups.Result The flap area in the ALTF group was significantly larger than that in the RFFF group,and the operation time,recovery or healing time were shorter than those in the RFFF group,and the differences were statistically significant(P<0.01).After 12 months followup,the scores of each dimension of the SF-36 scale in the two groups were higher than those before the treatment,and the scores in the ALTF group were higher than those in the RFFF group,and the differences were statistically significant(P<0.05).After 12 months follow-up,the total incidence of postoperative complications in the ALTF group was 1.82%,which was lower than 14.55% in the RFFF group,and the difference was statistically significant(P<0.05).The total satisfaction in the ALTF group was 98.18%,which was significantly higher than 76.36% of the RFFF group,and the difference was statistically significant(P<0.01).Conclusion Thin ALTF is better than RFFF in the repair of postoperative soft tissue defects in patients with tongue cancer.Moreover,the regimen could improve the quality of life of patients,reduce the incidence of postoperative complications such as poor blood supply of skin flaps,and improve their satisfaction.