廖宗生 巫家晓 毛远科 刘卿 邹高健 于慧珍

[摘要]目的：探討股前外侧皮瓣移植在口腔颌面部恶性肿瘤切除术后组织缺损患者中的应用效果及并发症情况。方法：选取2015年10月-2019年10月笔者医院收治的62例口腔颌面部恶性肿瘤患者。根据随机数字法分为对照组和观察组，每组31例。两组均行手术切除，术后均行口腔颌面部组织缺损修复。对照组应用前臂皮瓣进行治疗，观察组应用股前外侧皮瓣进行治疗。术后随访6个月，记录两组治疗效果、受区并发症情况、随访情况及满意度。结果：观察组与对照组总有效率比较，差异无统计学意义（P>0.05）。观察组并发症总发生率3.23%，低于对照组的19.35%（P<0.05）。随访期间，观察组异常情况总发生率0.00%，低于对照组异常情况总发生率12.90%（P<0.05）。观察组总满意度93.55%，高于对照组的74.19%（P<0.05）。结论：股前外侧皮瓣移植对口腔颌面部恶性肿瘤切除术后组织缺损患者具有良好的修复效果，可减少并发症，改善预后及满意度，值得临床推广应用。

[关键词]口腔颌面部恶性肿瘤;组织缺损;股前外侧皮瓣;前臂皮瓣;并发症

[中图分类号]R139.81    [文献标志码]A    [文章编号]1008-6455（2021）06-0151-04

Clinical Effect of Anterolateral Thigh Flap Transplantation in Repairing Tissue Defect after Resection of Malignant Tumor in Oral and Maxillofacial Area

LIAO Zong-sheng1， WU Jia-xiao2， MAO Yuan-ke1， LIU Qing1， ZOU Gao-jian1， YU Hui-zhen1

（1. Department of Stomatology， Hezhou People's Hospital， Hezhou  542899， Guangxi，China; 2. Department of Maxillofacial Surgery，Affiliated Hospital of Stomatology， Guangxi Medical University，Nanning 530000， Guangxi，China）

Abstract：Objective To investigate the application effect and complications of anterolateral thigh flap transplantation in patients with tissue defects after oral and maxillofacial malignant tumors resection. Methods Total of 62 patients with oral and maxillofacial malignant tumors in our hospital from October 2015 to October 2019 were selected. According to the random number method， the patients were divided into the control group （n=31） and the observation group （n=31）. Both groups were treated with surgical resection，and the oral and maxillofacial tissue defects were repaired postoperatively. The control group was treated with forearm flap transplantation， and the observation group was treated with anterolateral thigh flap transplantation. All the patients were followed up for 6 months postoperatively，the treatment effect， the incidence of complications in the recipient area， the conditions during follow-up period and the satisfaction of the two groups of patients were recorded. Results  There was no significant difference in the total effective rate between the observation group and the control group （P>0.05）. The total incidence of complications in the observation group （3.23%） was significantly lower than that in the control group （19.35%）， and the differences was statistically significant （P<0.05）. During the follow-up period， the total incidence of abnormal conditions in the observation group （0.00%） was significantly lower than that in the control group （12.90%）， and the differences was statistically significant （P<0.05）. The total satisfaction of the observation group （93.55%） was significantly higher than that in the control group （74.19%）， and the differences was statistically significant （P<0.05）. Conclusion  Anterolateral thigh flap transplantation has a good repair effect in patients with tissue defects after oral and maxillofacial malignant tumors resection， which can reduce the incidence of complications， improve the prognosis， and increase the satisfaction of patients， it is worthy of vigorous promotion and application.

Key words： oral and maxillofacial malignant tumors; tissue defects; anterolateral thigh flap; forearm flap; complications

口腔頜面部恶性肿瘤是口腔、颌面部及周围部位的恶性病变，大部分患者为鳞状细胞癌及腺性上皮癌，已成为临床多发的癌症类型[1-2]。目前，手术切除是主要治疗手段之一，被临床广泛应用。然而，恶性肿瘤切除术可能导致患者颌面部组织缺失、损伤，从而对患者的口腔颌面部功能及外貌美观造成一定影响，降低患者生存质量[3-4]。因此，采取合理、科学的措施修复恶性肿瘤切除术后组织缺损具有重要意义。随着口腔医学美学的不断发展，游离皮瓣移植技术在临床上受到了广泛认可[5]。游离皮瓣属于轴型皮瓣，是皮瓣与供区完全分离，转移至缺损部位并将其血管与受区相应血管吻合的皮瓣，常用于严重创伤、烧伤等导致的皮肤组织缺损的修复治疗中，具有良好的修复效果[6-7]。其中……