摘要
目的 探讨颏下岛状瓣(SMIF)在口腔癌(OC)根治术后软组织缺损修复中的应用价值.方法 选取 100例OC根治术后软组织缺损患者,按随机数字表法分为对照组(50 例)与观察组(50 例).对照组实施吻合血管游离前臂皮瓣修复,观察组实施SMIF修复,两组患者均观察到术后3 个月.对比两组手术相关指标、口腔开口度、吞咽与咀嚼功能、生活质量、并发症.结果 观察组术中出血量[(242.84±12.78)ml]少于对照组[(326.75±14.69)ml],手术与住院时间[(356.93±16.27)min、(13.29±2.82)d]短于对照组[(448.65±17.84)min、(17.48±3.46)d],而并发症发生率[6.00%(3/50)]低于对照组[20.00%(10/50)],有统计学差异(P<0.05);术前、术后,两组口腔开口度、吞咽与咀嚼功能、生活质量综合评定问卷(GQOLI-74)内的各维度评分相比,无统计学差异(P>0.05);但术后,两组口腔开口度、吞咽与咀嚼功能与GQOLI-74 内各项维度的评分均较术前高,有统计学差异(P<0.05).结论 SMIF与吻合血管游离前臂皮瓣修复均能够有效改善OC根治术后软组织缺损患者口腔开口度,提高其吞咽与咀嚼功能、生活质量,但SMIF修复具备出血量更低、手术及住院时间更短、并发症更少优点,值得临床大力推行.
Abstract
Objective To investigate the application value of submental island valve(SMIF)in the repair of soft tissue defects after radical resection of oral cancer(OC).Methods Select 100 patients with soft tissue defects after OC radical surgery and were divided into the control group(50 cases)and the observation group(50 cases)using a random number table method.The control group performed anastomotic vascular free forearm flap repair,and the observation group performed SMIF repair,which was observed at 3 months after surgery in both groups.Surgery-related indicators,oral opening degree,swallowing and masticatory func-tion,quality of life,and complications were compared between the 2 groups.Results The intraoperative bleeding volume in the observation group[(242.84±12.78)ml]was less than that in the control group[(326.75±14.69)ml],Surgery and length of stay[(356.93±16.27)min,(13.29±2.82)d]were shorter than the control group[(448.65±17.84)min,(17.48±3.46)d],However,the complication rate[6.00%(3/50)]was lower than that of the control group[20.00%(10/50)],there had statistical difference(P<0.05);Before and after surgery,Compared with the scores of the 2 dimensions of oral openness,swallo-wing and masticatory function,and quality of life comprehensive assessment questionnaire(GQOLI-74),there had no statistical difference(P>0.05);However,after the surgery,The scores of oral opening,swallowing and masticatory function and all dimen-sions within GQOLI-74 were higher than the preoperative scores,there had statistical difference(P<0.05).Conclusion Both SMIF and anastomotic vascular free forearm flap repair can effectively improve the oral opening of patients with radical OC,and improve their swallowing and masticatory function and quality of life.However,the SMIF repair has the advantages of lower bleed-ing volume,shorter operation and hospital stay,and fewer complications,which is worth clinical implementation.
维普
万方数据