黄静

【摘要】 目的 观察并比较舌瓣与颊脂垫瓣在老年颊部缺损修复中的临床效果及预后。方法 60例

老年颊部组织缺损患者， 按照修复方案不同分成舌瓣组和颊脂垫瓣组， 各30例。颊脂垫瓣組采用自体带蒂颊脂垫瓣修复方案， 舌瓣组给予舌瓣修复手术， 评价两组临床疗效及并发症发生情况。结果 颊脂垫瓣组患者术后3周左右出现上皮化和存活， 术后3个月已形成正常的口腔黏膜， 6个月后移植区与周围的正常区域趋同， 无痕迹；舌瓣组术后1周左右舌瓣转为正常红色。颊脂垫瓣组并发症发生率为6.7%， 舌瓣组并发症发生率6.7%， 比较差异无统计学意义（P>0.05）。颊脂垫瓣组修复总有效率为96.7%， 与舌瓣组的93.3%比较差异无统计学意义（P>0.05）。颊脂垫瓣组发音功能改善效果优于舌瓣组， 差异具有统计学意义（P<0.05）。结论 基于舌瓣与颊脂垫瓣的修复方案对于老年颊部缺损总体疗效相当， 手术风险小， 建议临床充分评估手术适应证后选择适宜的手术方案。

【关键词】 老年颊部缺损；舌瓣修复；颊脂垫瓣修复；疗效

DOI：10.14163/j.cnki.11-5547/r.2017.05.018

Curative effect analysis of senile buccal defects treated with tongue flap and buccal fat pad flap repair HUANG Jing. Integerated Department Two， Dalian City Stomatological Hospital， Dalian 116021， China

【Abstract】 Objective To observe and compare the clinical effect and prognosis of tongue flap and buccal fat pad flap in repair of senile buccal defects. Methods A total of 60 senile buccal defects patients were divided by different repair regimens into tongue flap group and buccal fat pad flap group， with 30 cases in each group. The buccal fat pad flap group received autologous pedicle buccal fat pad flap repair regimen， and the tongue flap group received tongue flap repair surgery. Evaluation were made on clinical effect and occurrence of complications. Results The buccal fat pad flap group had epithelium and survival in postoperative 3 weeks， normal oral mucosa in postoperative 3 months， and convergence of transplantation area and normal surrounding area with no trace in postoperative 6 months. The tongue flap group had normal red tongue flap in postoperative 1 week. The buccal fat pad flap group had incidence of complications as 6.7%， while the tongue flap group had incidence of complications as 6.7%， and the difference had no statistical significance （P>0.05）. The buccal fat pad flap group had total repair effective rate as 96.7%， which was 93.3% in the tongue flap group， and the difference had no statistical significance （P>0.05）. The buccal fat pad flap group had better pronunciation function improvement effect than the tongue flap group， and the difference had statistical significance （P<0.05）. Conclusion Based on the equal curative effect and small surgical risk between tongue flap and buccal fat pad flap repair for the treatment of senile buccal defects， it is suggested that suitable surgical regimens should be chosen after clinical fully evaluation of surgical indications.

【Key words】 Senile buccal defects； Tongue flap repair； Buccal fat pad flap repair； Curative effect

一般情况下， 口腔颊部因肿瘤或外伤手术会导致颊部组织缺损， 需要接受修复术以矫正口腔功能， 但不同的（植皮）修复方案对预期效果及并发症方面有着比较明显的影响。临床一般根据缺损部位、面部大小来确定针对性的修复方案， 目前常見的方案有前臂皮瓣、带蒂颊脂垫瓣及舌瓣修复， 部分学者倾向于认为后两者在口腔局部修复中更具价值[1-3]。本文即选取60例老年颊部缺损患者作为观察对象， 比较分析基于颊脂垫瓣与舌瓣修复的疗效差异性， 现报告如下。……