摘要
目的探讨下颌下腺瓣对口咽部组织缺损患者面形修复效果及口腔功能的影响。方法选取63例口咽部肿瘤切除术所致的口咽部组织缺损患者作为研究对象,所有患者均应用下颌下腺瓣进行修复。记录患者围术期指标(手术时间、皮瓣制作和吻合时间、术后经口进食时间),观察患者术后皮瓣成活情况和皮瓣黏膜化情况、外观满意度及并发症发生情况,比较患者手术前后吞咽功能(洼田饮水试验)、发音功能(基频、基频微扰、振幅微扰、最长发音时间)、咀嚼功能(咬合力、咀嚼效率)、疼痛程度(疼痛视觉模拟量表评分)及张口度。结果63例患者的手术时间、皮瓣制作和吻合时间、术后经口进食时间分别为(6.54±1.23)h、(1.07±0.21)h、(19.65±4.51)d。63例患者的皮瓣在术后1周均成活,均未出现皮瓣边缘坏死与皮瓣坏死,皮瓣在术后1个月或2个月内逐渐黏膜化,黏膜表面质地、外观逐渐趋于正常。所有患者术后面形恢复良好,外观满意度为88.89%(56/63);有7例患者发生颈部血肿,10例发生切口感染,术后并发症发生率为26.98%(17/63)。患者术后洼田饮水试验评级优于术前,基频微扰、振幅微扰均低于术前,基频、最长发音时间、咬合力、咀嚼效率均优于术前(均P<0.05);术前、术后2周、术后3个月患者的疼痛视觉模拟量表评分呈下降趋势,且患者的张口度呈增长趋势(均P<0.05)。结论下颌下腺瓣应用于口咽部肿瘤切除术导致的口咽部组织缺损修复,皮瓣成活率及外观满意度较高,术后并发症少,可改善患者的口腔功能,减轻患者术后疼痛和张口受限情况。
Objective To explore the effects of submandibular gland flap on facial reconstruction efficacy and oral function in patients with oropharyngeal tissue defect.Methods A total of 63 patients with oropharyngeal tissue defect caused by oropharyngeal tumor resection were selected as research subjects,and all patients received a reconstruction with submandibular gland flaps.Perioperative indicators(operation duration,duration of flap preparation and anastomosis,postoperative oral feeding time)of the patients were recorded.Flap survival state,flap mucosal conditions,appearance satisfaction,and the incidence of complications after operation of the patients were observed.Pre-and postoperative swallowing function(water swallow test),phonic function(fundamental frequency,fundamental frequency perturbation,amplitude perturbation,maximum phonation time),masticatory function(occlusal force,mastication efficiency),pain degree(the Visual Analogue Scale score for pain),and mouth opening were compared among the patients.Results The operation duration,duration of flap preparation and anastomosis,postoperative oral feeding time of the 63 patients were 6.54±1.23 h,1.07±0.21 h,and 19.65±4.51 d,respectively.Among the 63 patients,all the flaps survived after one week of operation,without presenting necrosis of flap edge or flap necrosis,and the flaps became mucosal gradually within one or two months after operation,exhibiting a tendency to become normal state in the mucosal surface texture and appearance.All patients achieved a favorable facial recovery after operation,with an appearance satisfaction of 88.89%(56/63).Seven patients had neck hematoma and 10 had incision infection,demonstrating an incidence rate of postoperative complications of 26.98%(17/63).After operation,the water swallow test rating of the patients was superior to that before operation,and fundamental frequency perturbation and amplitude perturbation were lower than those before operation,whereas fundamental frequency,maximum phonation time,occlusal force,and mast
作者
陆慧
焦建军
马超
李慧敏
LU Hui;JIAO Jian-jun;MA Chao;LI Hui-min(Department of Oral and Maxillofacial Surgery,Handan Central Hospital,Handan 056001,China)
出处
《广西医学》
CAS
2022年第10期1072-1076,1085,共6页
Guangxi Medical Journal
基金
河北省邯郸市科学技术研究与发展计划(19422083009-16)。
关键词
口咽部组织缺损
下颌下腺瓣
口咽部肿瘤切除术
面形修复
外观满意度
口腔功能
Oropharyngeal tissue defect
Submandibular gland flap
Oropharyngeal tumor resection
Facial reconstruction
Appearance satisfaction
Oral function
