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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2023年10期

页码:

29-32

栏目:

出版日期:

2023-10-10

文章信息/Info

Title:

Aesthetic Effect of Different Skin Flaps in Repairing Tissue Defect after Oral and Maxillofacial Malignancy and Its Infl uence on Blood Flow

文章编号:

1008-6455（2023）10-0029-04

作者:

杨文涛; 彭文文

(天门市第一人民医院口腔科 湖北 天门 431700 )

Author(s):

YANG Wentao; PENG Wenwen

(Department of Stomatology,Tianmen First People’s Hospital,Tianmen 431700,Hubei,China)

关键词:

口腔颌面部; 恶性肿瘤; 皮瓣; 组织缺损修复; 美学效果; 缺损; 血流状态

Keywords:

oral and maxillofacial;  malignant tumor;  fl ap;  tissue defect repair;  aesthetic eff ect;  defect;  blood fl ow status

分类号:

R739.81

DOI:

10.15909/j.cnki.cn61-1347/r.005960

文献标志码:

A

摘要:

目的：分析不同皮瓣对口腔颌面部恶性肿瘤手术后组织缺损修复的美学效果及缺损处血流状态的影响。方法：回顾性 选取2019年1月-2022年1月在笔者医院行手术治疗的98例口腔颌面部恶性肿瘤患者，均在完成肿瘤切除术后行组织缺损修复 术，根据其术中应用皮瓣的不同分为颈部带蒂组织瓣组（48例）和股前外侧皮瓣（Anterolateral thigh flap，ALTF）组 （50例），比较两组患者手术时间、皮瓣制作和显微吻合的时间；观察两组患者术后缺损修复效果，包括皮瓣成活率、外观 瘢痕评分及患者对外观的满意度；比较两种患者术后缺损处的血流状态[血管指数（Vascular index，VI）和血管血 流指数（Vascularization flow index，VFI）]及并发症发生率。结果：两组患者术中出血量比较差异无统计学意 义（P＞0.05）；ALTF组手术时间、皮瓣制作显微吻合时间较颈部带蒂组织瓣组长（P＜0.05）；ALTF组愈合时间短于颈部 带蒂组织瓣组（P＜0.05）。两组术后3月皮瓣成活率比较差异无统计学意义（P＞0.05）；ALTF组的外观瘢痕评分低于颈部 带蒂组织瓣组（P＜0.05）；ALTF组的外观满意度评分高于颈部带蒂组织瓣组（P＜0.05）。ALTF组术后1月及3月的VI及VFI 指数均高于颈部带蒂组织瓣组（F 时间值分别为353.412,187.621，F 组间值分别为14.430,6.452，均P＜0.05）。两组总并发症 发生率比较差异无统计学意义（8.33%vs4.00%）（P＞0.05）。结论：ALTF与颈部带蒂组织皮瓣的应用临床效果一致，各有 优势，在美学效果及缺损处血流状态的恢复中ALTF更胜一筹。

Abstract:

Objective To analyze the aesthetic effect of different flaps on tissue defects repair and the influence on blood fl ow status at defect site after oral and maxillofacial malignant tumors surgery. Methods A total of 98 patients with oral and maxillofacial malignant tumors undergoing surgical treatment in the author’s hospital were retrospectively enrolled between January 2019 and January 2022. All underwent tissue defects repair after tumor resection. According to diff erent intraoperative usage of fl aps, they were divided into cervical pedicled tissue fl ap group (48 cases) and anterolateral thigh fl ap (ALTF) group (50 cases). The operation time, fl ap fabrication time and micro-anastomosis time were compared between the two groups. The repair eff ects of postoperative defects in both groups were observed, including fl ap survival rate, scores of appearance scars and patients’ satisfaction with appearance. The blood fl ow status [vascular index (VI), vascularization fl ow index,VFI] at defect sites and incidence of complications were compared between the two groups. Results There was no signifi cant diff erence in intraoperative blood loss between the two groups (P ＞0.05). The operation time, fl ap fabrication time and micro-anastomosis time in ALTF group were longer than those in cervical pedicled tissue flap group (P ＜0.05), and healing time was shorter than that in cervical pedicled tissue fl ap group (P ＜0.05). At 3 months after surgery, there was no signifi cant diff erence in fl ap survival rate between the two groups (P ＞0.05). The score of appearance scars in ALTF group was lower than that in cervical pedicled tissue fl ap group (P ＜0.05), satisfaction score of appearance was higher than that in cervical pedicled tissue fl ap group (P ＜0.05). At 1 month and 3 months after surgery, VI and VFI in ALTF group were higher than those in cervical pedicle tissue fl ap group (Ftime=353.412, 187.621, Fbetween-group=14.430, 6.452, P＜0.05). There was no signifi cant diff erence in the total incidence of complications between the two groups (8.00% vs 4.00%) (P ＞0.05). Conclusion The clinical application eff ect of ALTF and cervical pedicled tissue fl ap is comparable, and they both have their own advantages. ALTF is superior in aesthetic eff ect and repair of blood fl ow status at defect sites.

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更新日期/Last Update: 2023-10-30