CAJ | 학술논문

目的比较上臂外侧皮瓣和前臂皮瓣修复口腔癌术后组织缺损的临床应用效果.方法对北京大学口腔医院口腔颌面外科2007-2009年收治的21例采用上臂外侧皮瓣和104例采用前臂皮瓣行口腔癌术后缺损修复的患者进行对比研究,比较两种皮瓣的手术制备时间、皮瓣移植成功率、供区并发症及术后口腔功能恢复情况.结果上臂外侧皮瓣和前臂皮瓣制备的平均手术时间((x)±s)为(46.4±7.6)min和(41.5±7.5) min,差异无统计学意义(P＞0.05).上臂外侧皮瓣和前臂皮瓣的移植成功率分别为90.5％( 19/21)和95.2％ (99/104),差异无统计学意义(P＞0.05).上臂外侧皮瓣供区可直接拉拢缝合,2例患者术后出现桡神经损伤症状；前臂皮瓣患者无供区并发症发生,但供区需行全厚皮片移植,于经常外露的前臂区域遗留手术瘢痕.两种皮瓣患者术后均能经口腔进软食或普通饮食,无发音不清.结论上臂外侧皮瓣供区隐蔽,无需植皮,移植成功率高,可作为前臂皮瓣的补充,进一步丰富了口腔癌组织缺损的修复手段.
목적 비교상비외측피판화전비피판수복구강암술후조직결손적림상응용효과.방법 대북경대학구강의원구강합면외과2007-2009년수치적21례채용상비외측피판화104례채용전비피판행구강암술후결손수복적환자진행대비연구,비교량충피판적수술제비시간、피판이식성공솔、공구병발증급술후구강공능회복정황.결과 상비외측피판화전비피판제비적평균수술시간((x)±s)위(46.4±7.6)min화(41.5±7.5) min,차이무통계학의의(P＞0.05).상비외측피판화전비피판적이식성공솔분별위90.5％( 19/21)화95.2％ (99/104),차이무통계학의의(P＞0.05).상비외측피판공구가직접랍롱봉합,2례환자술후출현뇨신경손상증상；전비피판환자무공구병발증발생,단공구수행전후피편이식,우경상외로적전비구역유류수술반흔.량충피판환자술후균능경구강진연식혹보통음식,무발음불청.결론 상비외측피판공구은폐,무수식피,이식성공솔고,가작위전비피판적보충,진일보봉부료구강암조직결손적수복수단.
Objective To compare the clinical application of lateral arm flap and radial forearm flap in reconstruction after oral cancer ablation.Methods The clinical data of 21 cases with lateral ann flap and 104 cases with radial forearm flap between 2007 and 2009 were reviewed.The flap harvest time,flap survival rate,donor site morbidity and postoperative oral function were compared and analyzed.Results The average flap harvest time of lateral ann flap and radial forearm flap were (46.4 ± 7.6 ) min and (41.5 ±7.5) min ((x) ±s) respectively.The flap survival rates of the two flaps were 90.5％ ( 19/21 ) and 95.2％ (99/104) respectively.There was no significant difference between the two flaps in the average flap harvest time and survival rate (P ＞ 0.05 ).The donor site of lateral arm flap could be primarily closed and radial nerve injury occurred in 2 patients.Skin graft was necessary for the donor site closure of radial forearm flap and conspicuous unattractive scar could be seen.All patients could have oral diet and no difficulty in speech intelligibility.Conclusion The lateral arm flap is relatively safe and reliable alterative to the radial forearm flap for the defects reconstruction after oral cancer ablation.