时荣新 张艳萍 刘恒林 杨锋

[摘要]目的：研究颏下岛状皮瓣（Submental island flap，SIF）与前臂游离皮瓣（Radialis forearm free flaps，RFFF）修复颌面部外伤软组织缺损并进行对比分析。方法：回顾性分析2014年3月-2019年6月笔者医院收治的84例颌面外伤性软组织缺损患者资料，根据手术方式不同分为RFFF组和SIF组，比较两组修复成功率、切口一期愈合率、手术操作时间、住院时间、术后生活质量和修复满意度，记录两组患者并发症发生情况。结果：SIF组的修复成功率、切口一期愈合率均高于RFFF组（P<0.05）;SIF组的手术操作时间、住院时间均少于RFFF组（P<0.05）;SIF组的吞咽、咀嚼、语言表达、味觉、进食、情绪和娱乐等评分均优于RFFF组（P<0.05）;SIF组的修复满意度为93.18%，高于RFFF组的77.50%（P<0.05）;SIF组术后并发症总发生率为4.54%，低于RFFF组的20.00%（P<0.05）。结论：SIF修复法在颌面部外伤性软组织缺损中的应用效果良好，修复成功率、切口一期愈合率高，手术操作时间、住院时间短，术后生活质量较好，患者满意度高，安全性好，对颌面外伤性软组织缺损的临床治疗有重要意義。

[关键词]颏下岛状皮瓣;颌面软组织缺损;游离皮瓣;临床效果

[中图分类号]R782.2    [文献标志码]A    [文章编号]1008-6455（2021）06-0154-03

Application of Submental Island Flap Repair in Maxillofacial Traumatic

Soft Tissue Defects

SHI Rong-xin1，ZHANG Yan-ping2， LIU Heng-lin1，YANG Feng1

[1.Department of Stomatology;2.Operating Room， Tengzhou Central People's Hospital （Tengzhou Hospital Affiliated to Xuzhou Medical University）， Tengzhou 277500，Shandong，China]

Abstract： Objective  To study the comparative analysis of submental island flap （SIF） repair and radial forearm free flap （RFFF） repair in maxillofacial traumatic soft tissue defects. Methods  A retrospective analysis was performed on the 84 patients with maxillofacial traumatic soft tissue defects who were admitted from March 2014 to June 2019. According to different surgical methods， they were divided into RFFF group and SIF group. The success rate of repair， healing rate of stage-I incision， operation time， hospitalization time， postoperative quality of life and repair satisfaction were compared between the two groups. The occurrence of complications in both groups was recorded. Results  The success rate of repair and healing rate of stage-I incision in SIF group were higher than those in RFFF group （P<0.05）， operation time and hospitalization time were shorter than those in RFFF group （P<0.05）， and scores of swallowing， chewing， language expression， taste， eating， mood and entertainment were all higher than those in RFFF group （P<0.05）. The repair satisfaction in SIF group was higher than that in RFFF group （93.18% vs 77.50%） （P<0.05）， while total incidence of postoperative complications was lower than that in RFFF group （4.54% vs 20.00%） （P<0.05）. Conclusion  The application effect of SIF repair is good in maxillofacial traumatic soft tissue defects， with high success rate of repair and healing rate of stage-I incision， short operation time and hospitalization time， good postoperative quality of life， high patient satisfaction and safety. it is of great significance in the clinical treatment of maxillofacial traumatic soft tissue defects.

Key words： submental island flap; maxillofacial soft tissue defect; free flap; clinical effect

作为口腔颌面外科的常见病，外伤性颌面软组织缺损主要由车祸、炸伤以及创伤等外部因素导致。由于颌面部属于人体特殊的暴露部位，对患者造成极大的心理创伤，极大地影响了患者的生活质量[1]。随着医疗技术的不断进步，皮瓣修复的应用已较为广泛[2]。一般的修复方法有局部皮瓣、游离皮瓣转移或植皮等[3]。既往研究中，面部缺损修复大多选择前臂游离皮瓣（Radialis forearm free flaps， RFFF），RFFF修复虽然皮瓣制备简单，修复面积大，但存在供区不隐蔽、无法提供肌肉层修复以及可能带来语言表达障碍等弊端[4]。国外学者[5]最早将颏下岛状皮瓣（Submental island flap， SIF）应用于临床修复面部肿瘤切除后缺损，之后SIF修复缺损面积大、供区损伤小、瘢痕较隐蔽和动脉解剖结构恒定等优点逐渐被临床研究者接受[6]。本研究对比分析SIF修复和RFFF修复修复颌面外伤性软组织缺损并观察其临床应用效果，现报道如下。……