口腔癌术后软组织缺损患者CTA及血管三维重建定位下股前外侧皮瓣的修复重建效果分析

Reconstruction effect analysis of inferior anterolateral femoral flap for patients with soft tissue defect after oral cancer under location of CTA and three-dimensional vascular reconstruction

目的分析口腔癌术后软组织缺损患者CT血管造影(CTA)及血管三维重建定位下股前外侧皮瓣的修复重建效果。方法回顾性分析2021年1月—2024年1月在本院确诊的60例口腔癌术后采用股前外侧皮瓣修复重建面部缺损软组织患者的临床资料,术前采用CTA及血管三维重建定位技术辅助设计制备皮瓣的32例患者作为A组,术前均采用彩色多普勒超声(CDU)定位辅助制备皮瓣的28例患者作为B组。收集两组患者临床资料,比较两组患者手术时间、皮瓣存活情况、移植区感觉功能以及术后并发症。比较不同影像标记穿支血管皮肤浅出点、起始点至髌骨上缘和至外侧缘直线距离以及动脉血管内径与术中实际测量值差值。结果A组手术时间较B组缩短(P<0.05);A组与B组皮瓣存活率比较无差异(P>0.05)。A组移植区皮瓣感觉功能优于B组(P<0.05)。A组总并发症发生率低于B组(9.38%vs 21.43%)(P<0.05)。A组穿支血管浅出点、起始点至髌骨上缘直线距离和起始点至大腿外侧缘直线距离以及血管内径术前测量值与术中测量值差值均小于B组(P<0.05)。结论CTA及血管三维重建技术可辅助临床医师定位穿支血管,指导手术方案的制定,提高临床效果,改善患者预后。

Objective To analyze the reconstruction effect of inferior anterolateral femoral flap in patients suffering from soft tissue defect after oral cancer under the location of CT angiography(CTA)and three-dimensional vascular reconstruction.Methods A total of 60 patients who were diagnosed as oral cancer and received femoral lateral flap repair for reconstruction of facial defect soft tissue at our hospital from January 2021 to January 2024 were retrospectively selected as study subjects.Group A consisted of 32 patients who had preoperative CTA and three-dimensional vascular reconstruction for flap design and preparation,while Group B included 28 patients who had preoperative color Doppler ultrasound(CDU)for flap localization and preparation.Clinical data from both groups were collected to compare operative time,flap survival,sensory function of the transplanted area,and postoperative complications.The distances from the skin surface marking of the perforator vessels to the superior and lateral edges of the patella,as well as the arterial vessel diameter,were compared between preoperative imaging measurements and intraoperative actual measurements.Results A total of 60 patients who were diagnosed as oral cancer and received femoral lateral flap repair for reconstruction of facial defect soft tissue at our hospital from January 2021 to January 2024 were retrospectively selected as study subjects.Group A consisted of 32 patients who had preoperative CTA and three-dimensional vascular reconstruction for flap design and preparation,while Group B included 28 patients who had preoperative color Doppler ultrasound(CDU)for flap localization and preparation.Clinical data from both groups were collected to compare operative time,flap survival,sensory function of the transplanted area,and postoperative complications.The distances from the skin surface marking of the perforator vessels to the superior and lateral edges of the patella,as well as the arterial vessel diameter,were compared between preoperative imaging measurements and intraoperative actual measurements.Conclusions CTA and 3D vascular reconstruction technology can assist clinicians to locate perforator vessels,guide the formulation of surgical plan,improve clinical effect,and enhance patient prognosis.