摘要
目的探讨游离前臂皮瓣移植修复治疗口腔颌面部肿瘤切除后缺损的临床效果。方法回顾性分析温州医科大学附属第一医院2013年1月—2015年12月间收治的47例口腔颌面部肿瘤患者病例,患者肿瘤切除术后均给予游离前臂皮瓣移植修复治疗。统计患者皮瓣成活及并发症情况,对患者吞咽功能、语音功能进行评价,并对患者治疗前后血清唾液酸(SA)和白细胞介素(IL)-2水平变化进行比较。结果所有患者均进行手术,经病灶切除、皮瓣设计、皮瓣切取、吻合修复等步骤对患者进行修复治疗。术后随访6~18个月,皮瓣成活率达到了95.7%(45/47)。术后1个月,患者血清SA水平为(0.72±0.24)mg/L,显著低于术前的(0.96±0.27)mg/L(P<0.05);术后1个月,患者血清IL-2水平为(13.94±4.12)μg/L,显著高于术前的(5.69±1.38)μg/L(P<0.05)。术后3个月,患者吞咽功能:2级9例(19.1%)、3级38例(80.9%)。术后6个月,34例(72.3%)患者发音清晰。并发症包括:瘢痕14例(29.8%)、色素沉着39例(83.0%)、瘙痒24例(51.1%)、皮区感觉异常43例(91.5%)。结论游离前臂皮瓣修复治疗口腔颌面部组织缺损效果满意,皮瓣成活率高、吞咽功能恢复良好。
Objective To investigate the effect of free forearm flap in the treatment of oral and maxillofacial defects after tumor resection. Methods The clinical data of 47 cases of oral and maxillofacial tumor patients in our hospital from January,2013 to December,2015 were retrospective analyzed. All patients were given tumor resection,and the defects were repaired by forearm flap. After the surgery,the flap survival rate,swallowing function,pronounce function complications were observed,also the changes of serum sialic acid（ SA） and interleukin（ IL）-2 levels before and after treatment were observed. Results All patients were treated with surgery at the first time and the repair treatment included excision,flap design,cut flap,anastomotic repair. The patients were followed up for 6 to 18 months; the flap survival rate reached95. 7%（ 45 /47）. After 1 month,the SA level of patients was（ 0. 72 ± 0. 24） mg / L,which was significantly lower than before surgery（ 0. 96 ± 0. 27） mg / L（ P 〈0. 05）,and IL-2 level of patients was（ 13. 94 ± 4. 12） μg / L,which was significantly higher than before surgery（ 5. 69 ± 1. 38） μg / L（ P 〈0. 05）. After 3 month,swallowing function： 2 grade 9 cases（ 19. 1%）,3 grade 38 cases（ 80. 9%）. After 6 months,34 cases（ 72. 3%） patients can clearly pronounce. The complications included： scar 14 cases（ 29. 8%）,pigmentation 39 cases（ 83. 0%）,itching 24 patients（ 51. 1%）,and skin abnormal feel 43 cases（ 91. 5%）. Conclusion The forearm free flap can treat oral and maxillofacial defects after tumor resection with satisfactory efficacy. The flap survival rate is high and swallowing function and pronunciation function is recovered well.
出处
《中华全科医学》
2017年第2期206-209,共4页
Chinese Journal of General Practice
基金
国家自然科学基金面上项目(81271663)
