SIMF和FSG修复老年患者颊癌术后缺损的对照研究

发布时间：2019-04-26 20:43

【摘要】：目的探讨颏下岛状皮瓣(SIMF)和游离皮片(FSG)在修复老年患者颊癌术后颊部缺损的临床应用效果。方法 44例老年颊癌患者行颊癌根治术和颈淋巴清扫术后同期分别应用颏下SIMF(n=19)和FSG(n=25)修复颊部缺损。比较两组患者术后颊部外形恢复程度、开口受限程度、语音功能、咀嚼功能等情况。结果 SIMF组1例出现皮岛坏死,清创后发现肌瓣血运良好,其余全部成活,皮瓣移植成功率94.7%(18/19),供区直接拉拢缝合FSG组的移植成功率为100.0%(25/25);SIMF组所有病例术后12个月随访,颊部外形恢复程度、张口受限程度、语音功能、咀嚼功能均优于FSG组(P0.05)。FSG组有1例术后5月出现原发灶复发。两组间在复发转移情况方面差异无统计学意义(P0.05)。结论颏下SIMF适合老年患者颊癌切除术后组织缺损的修复,提高了患者术后生存质量,具有较好的临床应用前景。
[Abstract]:Objective to investigate the clinical application of submental island flap (SIMF) and free skin graft (FSG) in repairing buccal defect after buccal cancer in elderly patients. Methods 44 elderly patients with buccal carcinoma were treated with submental SIMF (n = 19) and FSG (n = 25) to repair buccal defects at the same time after radical resection of buccal carcinoma and neck dissection. The buccal shape recovery degree, opening limitation degree, speech function and masticatory function were compared between the two groups. Results skin island necrosis was found in 1 case in SIMF group. After debridement, the blood flow of myocutaneous flap was good, and all survived. The successful rate of flap transplantation was 94.7% (18 / 19), and the success rate of direct closure of donor region was 100.0% (25 / 25) in FSG group. After 12 months follow-up, the buccal shape recovery, mouth opening limitation, speech function and masticatory function in SIMF group were better than those in FSG group (P0.05). The recurrence of primary foci occurred in 1 case in). FSG group (P0.05). There was no significant difference in recurrence and metastasis between the two groups (P0.05). Conclusion submental SIMF is suitable for the repair of tissue defect after resection of buccal cancer in elderly patients. It can improve the quality of life after operation and has a good clinical application prospect.
【作者单位】：四川省达州市中心医院口腔科;重庆医科大学附属口腔医院口腔外科;重庆市口腔疾病与生物医学重点实验室;
【基金】：重庆市卫生局科研基金项目(07-2-178)
【分类号】：R739.8

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