抗凝干预对口腔癌患者皮瓣移植术成功率及血栓形成并发症的影响

Effects of Anticoagulation Intervention on Success rate of Skin Flap Grafting and Thrombosis Complications in Patients with oral Cancer

目的观察抗凝干预对口腔癌患者皮瓣移植术成功率及血栓形成的影响。方法收集我院口腔科2010年4月到2015年12月收治的口腔癌患者66例作为研究对象,按照随机数字表随机分为观察组(n=36)与对照组(n=30)。两组均于全麻下行肿瘤根治性切除术,术后予以常规护理措施(包括观察生命体征变化、体位护理、皮瓣观察、饮食护理等),观察组在常规护理基础上联合抗凝干预。比较两组皮瓣移植术成功率、创面愈合结果及术后血栓形成的发生率。结果观察组皮瓣移植术成功率达100.0%(36/36),高于对照组86.7%(26/30)(P<0.05);观察组创面的甲级愈合率为66.7%(24/36),高于对照组的40.0%(12/30),(P<0.05);观察组术后无静脉血栓形成出现,对照组为13.4%(4/30)(P<0.05);观察组皮瓣并发症发生率为2.8%(1/36),低于对照组13.4%(4/30)(P<0.05)。结论抗凝干预在口腔癌皮瓣移植术患者中的应用利于提高手术成功率、促进创口愈合并预防血栓形成,具有较大临床应用价值。

Objective To observe effects of anticoagulation intervention on success rate of skin flap grafting and thrombosis in patients with oral cancer. Methods 66 patients with oral cancer treated in department of stomatology in our hospital from April 2010 to December 2015 were enrolled in the study,they were divided by random number table into the observation group( n = 36) and the control group( n = 30). The two groups received radical resection for tumor under general anesthesia,routine nursing measures were given to the two groups after the operation( including observation of changes of vital signs,body position nursing care,skin flap observation,diet nursing and others),the observation group added anticoagulant intervention on the basis of routine nursing. Success rate of skin flap grafting,wound healing and postoperative thrombosis rate in the two groups were compared. Results Success rate of skin flap grafting of the observation group was100%( 36 /36),higher than the control group 86. 7%( 26 /30)( P < 0. 05); wound healing rate of grade in the observation group was 66. 7%( 24 /36),higher than the control group 40. 0%( 12 /30)( P < 0. 05); no venous thrombosis occurred after the operation in the observation group,the control group was 13. 4%( 4 /30)( P <0. 05); skin flap complication rate of the observation group was 2. 8%( 1 /36),which was slightly lower than the control group 13. 4%( 4 /30)( P < 0. 05). Conclusion Application of anticoagulation intervention in treating oral cancer skin flap grafting patients is beneficial to increase success rate of the operation,promote wound healing and prevent thrombosis,is of great clinical value.