南昌大学学报（医学版）
南昌大學學報（醫學版）
남창대학학보（의학판）
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
11期
24-26,39
,共4页
舌根癌%胸大肌肌皮瓣%生存质量
舌根癌%胸大肌肌皮瓣%生存質量
설근암%흉대기기피판%생존질량
tongue base cancer%pectoralis major myocutaneous flap%quality of life
目的：探讨胸大肌肌皮瓣修复晚期舌根癌术后缺损的临床效果。方法回顾性分析2006年8月至2013年12月在南方医科大学附属南方医院口腔医院住院治疗的行带蒂胸大肌肌皮瓣修复20例舌根癌术后局部缺损患者的临床资料。观察20例患者术后6个月舌体外形、语音及口咽功能恢复情况，并对20例患者术前、术后6个月功能恢复进行评分（采用华盛顿大学生存质量问卷表评分）。结果20例患者中，19例术后肌皮瓣均成活，切口Ⅰ期愈合；1例切口二期愈合。20例供区切口均Ⅰ期愈合。行放疗后，患者皮瓣均未出现坏死。20例患者术后6个月舌体外形、语音及口咽功能恢复满意。16例语音清晰；4例语音不清晰，但不影响交流，经过语音功能训练后，均达到语音清晰。20例患者 术 后6个 月 活 力、咀嚼、味觉、唾液和肩功能得分与术前比较差异均无统计学意义（P ＞0．05），而疼痛、外貌、娱乐、吞咽、语言、情绪和焦虑得分均明显高于术前（均 P ＜0．05）。结论采用胸大肌皮瓣进行修复和重建晚期舌根癌术后缺损，可获得良好的功能和整体生存质量。
目的：探討胸大肌肌皮瓣脩複晚期舌根癌術後缺損的臨床效果。方法迴顧性分析2006年8月至2013年12月在南方醫科大學附屬南方醫院口腔醫院住院治療的行帶蒂胸大肌肌皮瓣脩複20例舌根癌術後跼部缺損患者的臨床資料。觀察20例患者術後6箇月舌體外形、語音及口嚥功能恢複情況，併對20例患者術前、術後6箇月功能恢複進行評分（採用華盛頓大學生存質量問捲錶評分）。結果20例患者中，19例術後肌皮瓣均成活，切口Ⅰ期愈閤；1例切口二期愈閤。20例供區切口均Ⅰ期愈閤。行放療後，患者皮瓣均未齣現壞死。20例患者術後6箇月舌體外形、語音及口嚥功能恢複滿意。16例語音清晰；4例語音不清晰，但不影響交流，經過語音功能訓練後，均達到語音清晰。20例患者 術 後6箇 月 活 力、咀嚼、味覺、唾液和肩功能得分與術前比較差異均無統計學意義（P ＞0．05），而疼痛、外貌、娛樂、吞嚥、語言、情緒和焦慮得分均明顯高于術前（均 P ＜0．05）。結論採用胸大肌皮瓣進行脩複和重建晚期舌根癌術後缺損，可穫得良好的功能和整體生存質量。
목적：탐토흉대기기피판수복만기설근암술후결손적림상효과。방법회고성분석2006년8월지2013년12월재남방의과대학부속남방의원구강의원주원치료적행대체흉대기기피판수복20례설근암술후국부결손환자적림상자료。관찰20례환자술후6개월설체외형、어음급구인공능회복정황，병대20례환자술전、술후6개월공능회복진행평분（채용화성돈대학생존질량문권표평분）。결과20례환자중，19례술후기피판균성활，절구Ⅰ기유합；1례절구이기유합。20례공구절구균Ⅰ기유합。행방료후，환자피판균미출현배사。20례환자술후6개월설체외형、어음급구인공능회복만의。16례어음청석；4례어음불청석，단불영향교류，경과어음공능훈련후，균체도어음청석。20례환자 술 후6개 월 활 력、저작、미각、타액화견공능득분여술전비교차이균무통계학의의（P ＞0．05），이동통、외모、오악、탄인、어언、정서화초필득분균명현고우술전（균 P ＜0．05）。결론채용흉대기피판진행수복화중건만기설근암술후결손，가획득량호적공능화정체생존질량。
ABSTRACT:Objective To investigate the clinical efficacy of pectoralis major myocutaneous flap for the reconstruction of defects after surgery for advanced tongue base cancer(PMMF).Methods Clinical data of 20 patients with PMMF who underwent the reconstruction of postoperative de-fects with pectoralis major myocutaneous flap in the Stomatological Hospital of Nanfang Hospital Affiliated to Southern Medical University between August 2006 and December 2013 were ana-lyzed retrospectively.The tongue body shape,phonation and oropharyngeal function were ob-served 6 months after operation.In addition,the quality of life of patients was assessed using the University of Washington Quality of Life questionnaire before and 6 months after operation.Re-sults Among the 20 patients,flaps survived and incisions healed by first intention in 19,and inci-sions healed by second intention in 1.All donor site incisions healed by first intention.No flap necrosis occurred in all patients after radiotherapy.Furthermore,all patients had satisfactory tongue body shape,phonation and oropharyngeal function 6 months after operation.Moreover,16 patients had clear phonation,and 4 patients had unclear phonation which did not affect the com-munication.However,the 4 patients achieved clear phonation after phonation training.There were no significant differences in the vitality,chew,gustation,saliva and shoulder function scores be-fore operation and 6 months after operation(P >0.05).Compared with preoperative scores,the pain,appearance,entertainment,swallowing,language,emotion and anxiety scores significantly in-creased 6 months after operation(P <0.05).Conclusion The reconstruction of postoperative de-fects with pectoralis major myocutaneous flap can restore the swallowing and speech function and improve the quality of life in patients with PMMF.
