鼻唇沟皮瓣在口腔癌术后软组织缺损中的应用

Nasolabial flap in postoperative soft tissue defects after oral cancer surgery

目的 分析鼻唇沟皮瓣在口腔癌术后软组织缺损中的修复效果。方法 选择2020年6月至2023年6月在焦作解放惠仁医院接受治疗的46例口腔癌患者为研究对象。所有患者均行口腔癌根治术联合自体移植鼻唇沟皮瓣术治疗,记录皮瓣存活率,记录术后6个月的并发症、口腔功能评分及修复效果。结果 手术时间7~11 h,平均(9.12±0.89)h;皮瓣存活率97.83%(45/46),皮瓣坏死率2.17%(1/46);并发症发生率6.52%(3/46),其中植皮区色素沉着1例,植皮区感觉异常1例,植皮区麻木1例。所有患者口腔颌面颈部创面一期愈合。术后6个月吞咽功能、语言功能、张口功能评分均高于术前,差异有统计学意义(P<0.05)。软腭、舌根、咽侧壁的手术时间、皮瓣存活率、并发症发生率比较,差异无统计学意义(P>0.05)。软腭、舌根、咽侧壁术后6个月的张口功能评分比较,差异无统计学意义(P>0.05)。咽侧壁术后6个月的吞咽功能、语言功能评分高于软腭、舌根,差异有统计学意义(P<0.05)。软腭、舌根术后6个月的吞咽功能、语言功能评分比较,差异无统计学意义(P>0.05)。结论 自体移植鼻唇沟皮瓣修复口腔癌术后软组织缺损的皮瓣存活率高,并发症少,还可有效改善患者的吞咽功能、语言功能、张口功能。

Objective To analyze the repair effect of nasolabial fold flap in soft tissue defects after oral cancer surgery.Methods Select 46 oral cancer patients who received treatment at Jiaozuo Jiefang Huiren Hospital from June 2020 to June 2023 as the research subjects.All patients underwent radical surgery for oral cancer combined with autologous transplantation of nasolabial fold skin flap.The survival rate of the skin flap was recorded,and the postoperative complications,oral function score,and repair effect were recorded at 6 months.Results The operation time was 7-11 hours,with an average of(9.12±0.89)hours;The survival rate of the skin flap was 97.83%(45/46),and the necrosis rate of the skin flap was 2.17%(1/46);The incidence of complications was 6.52%(3/46),including 1 case of pigmentation in the skin graft area,1 case of abnormal sensation in the skin graft area,and 1 case of numbness in the skin graft area.All patients had oral,maxillofacial and neck wounds healed initially.The swallowing function,language function and mouth opening function scores were higher than the preoperative scores,and the difference was significant(P<0.05).The operation time,flap survival rate,and complication rate were not significant(P>0.05).The mouth opening function scores were compared 6 months after the soft palate,tongue root and pharyngeal wall(P>0.05).The swallowing function and language function scores were higher than those of the soft palate and tongue root,which were statistically significant(P<0.05).No significant difference of swallowing function and language function scores at 6 months after soft palate and tongue root surgery(P>0.05).Conclusions The patients with soft tissue defect after oral cancer have high flap survival rate and few complications,but also can effectively improve the swallowing function,language function and mouth opening function,especially in patients with lateral pharyngeal wall,which is worthy of clinical promotion.