摘要
目的:探讨带蒂下颌下腺瓣对高龄患者口腔肿瘤切除术后缺损的修复及对面部功能恢复与并发症的影响。方法:选取2017年1月-2019年1月于笔者医院就诊的33例口腔肿瘤患者为研究对象,均于口腔根治术后行带蒂下颌下腺瓣移植术,其中面颊部8例,牙龈部10例,舌底部15例,记录患者手术情况。随访12个月,评价患者面部功能恢复效果、并发症及生活质量。结果:33例患者手术均成功,平均手术时间(5.82±0.24)h,平均术中出血量(200.31±10.42)ml,拔除胃管时间(16.32±2.35)d,经口进食时间(17.45±2.41)d,组织愈合时间(10.35±1.32)d;末次随访时,患者平均外形修复评分(7.83±0.15)分,满意度(9.32±0.45)分,工作状态(8.05±0.20)分,口腔开合功能(8.64±0.36)分,张口度(8.56±0.34)分,进食情况(8.58±0.35)分,口腔容纳水测试(8.52±0.33)分,吞咽功能(8.66±0.37)分,咀嚼功能(9.15±0.46)分,语言功能(8.37±0.31)分,咬合功能(8.74±0.39)分,并发症发生率为3.03%(1/33);手术后口腔健康影响程度量表(OHIP-14)生理性疼痛、生理障碍、心理不适、心理障碍、功能限制、社交障碍、残障各项评分低于手术前,差异有统计学意义(均P<0.001)。结论:在高龄患者口腔肿瘤切除术后缺损修复中应用带蒂下颌下腺瓣可获得满意的修复效果,患者面部功能恢复情况良好、并发症发生率较低,生活质量提高。
Objective To explore the effect of the pedicled submandibular gland flap on the repair of the defect after the resection of the elderly oral tumors and on the recovery of facial function and complications.Methods Thirty-three patients with oral tumors who were treated in our hospital from January 2017 to January 2019 were selected as the research objects.All of them underwent pedicled submandibular gland flap transplantation after radical oral surgery,including 8 cases in the cheek and 10 cases in the gum,15 cases on the bottom of the tongue,record the operation status of the patients.Follow up for 12 months to evaluate the patient’s facial function recovery effect,complications and quality of life.Results All 33 patients were successfully operated.The average operation time was(5.82±0.24)h,the average intraoperative blood loss was(200.31±10.42)ml,the time to remove the gastric tube was(16.32±2.35)d,and the oral feeding time was(17.45±2.41)d,Tissue healing time(10.35±1.32)d.At the last follow-up,the patients had an average shape restoration score of(7.83±0.15),satisfaction(9.32±0.45),working status(8.05±0.20),oral opening and closing function(8.64±0.36),mouth opening(8.56±0.34)points,eating status(8.58±0.35)points,oral cavity water test(8.52±0.33)points,swallowing function(8.66±0.37)points,chewing function(9.15±0.46)points,language function(8.37±0.31)points,bite function(8.74±0.39)points.The complication rate was 3.03%(1/33).The Oral Health Impact Rating Scale(OHIP-14)after surgery(OHIP-14)scores of physical pain,physical disorder,psychological discomfort,psychological disorder,functional limitation,social disorder,and disability were lower than before surgery(all P<0.001).Conclusion The application of the pedicled submandibular gland flap in the defect repair of elderly patients after oral tumor resection can obtain satisfactory repair results.The patient’s facial function recovery is good,the incidence of complications is low,and the quality of life is improved.
作者
陆慧
焦建军
马超
李慧敏
张学强
LU Hui;JIAO Jianjun;MA Chao;LI Huimin;ZHANG Xueqiang(Department of Oral and Maxillofacial Surgery,Handan Central Hospital,Handan 056001,Hebei,China)
出处
《中国美容医学》
CAS
2022年第11期98-101,共4页
Chinese Journal of Aesthetic Medicine
基金
邯郸市科技局项目(名称:下颌下腺瓣修复口咽部肿瘤术后缺损的临床研究,编号:19422083009-16)。
关键词
口腔肿瘤
带蒂下颌下腺瓣
组织缺损
创面修复
pedicled submandibular gland flap
oral tumor resection
tissue defect
wound repair
