摘要
目的比较血管化下段胸锁乳突肌皮瓣和颏下岛状皮瓣在头颈部肿瘤术后口腔颌面部缺损一期修复的临床效果。方法 63例头颈部鳞癌术后口腔颌面部缺损采用血管化下段胸锁乳突肌皮瓣(A组,28例)或颏下岛状皮瓣(B组,35例)修复,分析两组的临床资料,比较两组皮瓣面积、制取时间、血管蒂长、皮瓣成活率和局部并发症。结果 A组皮瓣面积小于B组[(32.1±11.7)cm2vs.(54.2±20.4)cm2](P<0.05)。A、B两组皮瓣血管蒂长相仿[(7.9±1.0)cm vs.(8.1±1.1)cm](P>0.05);两组皮瓣制取时间无统计学差异[(58.9±5.3)min vs.(56.8±5.4)min](P>0.05)。A、B两组皮瓣成活率均很高[96.4%(27/28)vs.97.1%(34/35)](P>0.05)。A组有1例口底癌患者皮瓣坏死,甲状腺上动脉内血栓形成,后改用胸大肌皮瓣修复。B组有1例因为术区感染导致皮瓣部分坏死,后经术区换药后瘢痕愈合。两组皮瓣局部并发症发生情况相仿(P>0.05)。结论血管化下段胸锁乳突肌皮瓣和颏下岛状皮瓣各具有优缺点及适应证,均适用于头颈部恶性肿瘤患者术后缺损修复,成活率高。
Objective To compare the efficacy of the vascularized sternocleidomastoid flaps（VSCMF）and submental island flap（SIF）in the reconstruction of oral and maxillofacial defects immediately following the resection of head and neck cancers.Methods A total of 63 cases with head and neck squamous cell carcinomas underwent radical operation and the soft tissue defects after surgeries was immediately reconstructed with VSCMF（group A,28cases）or SIF（group B,35cases）.The clinical data of 63 cases were retrospectively analyzed,which included the areas and time for making,vessels pedicle length,survival rate,and local complications of the flaps.Results The area of group A was larger than that of group B[（32.1±11.7）cm^2 vs.（54.2±20.4）cm^2]（P〈0.05）.There were no significant differences in the vessels pedicle length[（7.9±1.0）cm vs.（8.1±1.1）cm]and the time for flap making[（58.9±5.3）min vs.（56.8±5.4）min]in groups of A and B（P〈0.05）.The survival rates of the flaps in groups of A and B were higher[96.4%（27/28）vs.97.1%（34/35）]（P〈0.05）.Skin flap necrosis occurred secondary to the thrombosis in the superior thyroid artery in one case of group A,for whom the reconstruction was performed using musculi pectoralis major.Skin flap necrosis occurred secondary to wound infection in one case of group B,which was cured with scar healing after dressing changes.The local complications of the flaps in both groups were similar（P〉0.05）.Conclusion The VSCMF and SIF have their own advantages,disadvantages and indications,which are suitable for the reconstruction of surgical defects after resection of head and neck cancers with higher survival rates.
出处
《江苏医药》
CAS
2017年第2期118-121,共4页
Jiangsu Medical Journal
关键词
头颈部肿瘤
血管化下段胸锁乳突肌皮瓣
颏下岛状皮瓣
口腔颌面部缺损修复
Head and neck cancer
Vascularized sternocleidomastoid flap
Submental island flap
Reconstruction of oral and maxillofacial defects
