CAJ | 학술논문

目的：探讨股前外侧皮瓣和前臂皮瓣在半舌缺损修复中的效果。方法收集37例舌前2／3外侧缘鳞状细胞癌患者，根据使用皮瓣的类型分为前臂皮瓣组（n＝16）和股前皮瓣组（n ＝21）。前臂皮瓣组采用前臂桡侧皮瓣修复，股前皮瓣组采用股前外侧皮瓣修复，比较两组随访期间供、受区并发症、吞咽功能、语言清晰度等情况。结果前臂皮瓣组患者瓣移植术后的吞咽功能、语言功能优良率分别为87．5％（14／16）、81．2％（13／16）；股前皮瓣组分别为95．2％（20／21）、85．7％（18／21），两组比较差异无统计学意义（P＞0．05）。前臂皮瓣组、股前皮瓣组受区并发症发生率分别为6．3％（1／16）、9．6％（2／21），两组比较差异无统计学意义（P ＞0．05）。前臂皮瓣组皮肤部分坏死、明显瘢痕、局部麻木、运动功能障碍发生率分别为31．3％（5／16）、81．3％（13／16）、62．5％（10／16）、25．0％（4／16），明显高于股前皮瓣组的0％、4．8％（1／21）、9．5％（2／21）、0％，差异有统计学意义（P＜0．05或P＜0．01）。结论股前外侧皮瓣是修复半舌缺损的较理想的组织瓣。
목적：탐토고전외측피판화전비피판재반설결손수복중적효과。방법수집37례설전2／3외측연린상세포암환자，근거사용피판적류형분위전비피판조（n＝16）화고전피판조（n ＝21）。전비피판조채용전비뇨측피판수복，고전피판조채용고전외측피판수복，비교량조수방기간공、수구병발증、탄인공능、어언청석도등정황。결과전비피판조환자판이식술후적탄인공능、어언공능우량솔분별위87．5％（14／16）、81．2％（13／16）；고전피판조분별위95．2％（20／21）、85．7％（18／21），량조비교차이무통계학의의（P＞0．05）。전비피판조、고전피판조수구병발증발생솔분별위6．3％（1／16）、9．6％（2／21），량조비교차이무통계학의의（P ＞0．05）。전비피판조피부부분배사、명현반흔、국부마목、운동공능장애발생솔분별위31．3％（5／16）、81．3％（13／16）、62．5％（10／16）、25．0％（4／16），명현고우고전피판조적0％、4．8％（1／21）、9．5％（2／21）、0％，차이유통계학의의（P＜0．05혹P＜0．01）。결론고전외측피판시수복반설결손적교이상적조직판。
Objective To investigate the effect of anterolateral thigh flap and radial forearm flap in reconstructing half tongue defect.Methods A total of 37 patients with anterior lingual 2/3 lateral margin squamous cell carcinoma were included,according to flap type,they were divided into forearm flap group(n=16) and anterolateral flap group (n=21).The forearm flap group were reconstructed by radial forearm flap,the anterolateral flap group were reconstructed by anterolateral thigh flap .During follow-up, the donating and receiving area complications, swallowing function, language clarity were compared between the two group. Results The excellent and good rate of swallowing function ,language function in the forearm flap group were 87.5%(14/16),81.2%(13/16) respectively,in the anterolateral flap group were 95.2%(20/21), 85.7%(18/21) respectively,there was no significant difference between the two groups(P >0.05).The incidence of complications of receiving area in the forearm flap group and in the anterolateral flap group were 6.3%(1/16),9.6%(2/21) respectively,there was no significant difference between the two groups(P>0.05).The incidence of partial skin necrosis,obvious scar,local numbness,movement dysfunction in the forearm flap group were 31.3%(5/16),81.3%(13/16),62.5%(10/16),25.0%(4/16) respectively, significantly higher than the anterolateral flap group[0%,4.8%(1/21),9.5%(2/21),0%](P<0.05 or P<0.01 ) .Conclusion The anterolateral thigh flap is an ideal flap for reconstruction of half tongue defect .