中华口腔医学杂志
中華口腔醫學雜誌
중화구강의학잡지
Chinese Journal of Stomatology
2015年
10期
607-610
,共4页
任振虎%吴汉江%谭宏宇%王铠%龚朝建%张胜
任振虎%吳漢江%譚宏宇%王鎧%龔朝建%張勝
임진호%오한강%담굉우%왕개%공조건%장성
外科皮瓣%口腔肿瘤%修复外科手术%股前外侧皮瓣
外科皮瓣%口腔腫瘤%脩複外科手術%股前外側皮瓣
외과피판%구강종류%수복외과수술%고전외측피판
Surgical flaps%Mouth neoplasms%Reconstructive surgical procedures%Anterolateral thigh flap
目的 探讨患者年龄对游离股前外侧皮瓣围手术期并发症的影响.方法 回顾2002年2月至2013年3月在中南大学湘雅二医院口腔颌面外科行口腔癌根治并行游离股前外侧皮瓣同期修复的1 100例患者(1 132块),所有患者分为A组(＜60岁)781例、B组(≥60岁)319例,记录并统计所有患者的围手术区并发症.结果 两组皮瓣总成功率97.2％(1 100/1 132)[A组97.3％(781/803)、B组97.0％(319/329)],两组差异无统计学意义(P＞0.05);并发症总发生率27.5％ (302/1 100)[A组25.9％(202/781)、B组31.3％(100/319)],两组差异无统计学意义(P=0.064).多因素分析显示,并发症的发生与美国麻醉医师协会患者分级(P＜0.001)、手术时间(P=0.021)、患者是否伴发疾病(P=0.002)有关,而与患者年龄无明显相关(P＞0.05).结论 高龄并不增加游离股前外侧皮瓣一期重建口腔癌术后缺损围手术期并发症;控制手术时间可有效减少围手术期并发症发生.
目的 探討患者年齡對遊離股前外側皮瓣圍手術期併髮癥的影響.方法 迴顧2002年2月至2013年3月在中南大學湘雅二醫院口腔頜麵外科行口腔癌根治併行遊離股前外側皮瓣同期脩複的1 100例患者(1 132塊),所有患者分為A組(＜60歲)781例、B組(≥60歲)319例,記錄併統計所有患者的圍手術區併髮癥.結果 兩組皮瓣總成功率97.2％(1 100/1 132)[A組97.3％(781/803)、B組97.0％(319/329)],兩組差異無統計學意義(P＞0.05);併髮癥總髮生率27.5％ (302/1 100)[A組25.9％(202/781)、B組31.3％(100/319)],兩組差異無統計學意義(P=0.064).多因素分析顯示,併髮癥的髮生與美國痳醉醫師協會患者分級(P＜0.001)、手術時間(P=0.021)、患者是否伴髮疾病(P=0.002)有關,而與患者年齡無明顯相關(P＞0.05).結論 高齡併不增加遊離股前外側皮瓣一期重建口腔癌術後缺損圍手術期併髮癥;控製手術時間可有效減少圍手術期併髮癥髮生.
목적 탐토환자년령대유리고전외측피판위수술기병발증적영향.방법 회고2002년2월지2013년3월재중남대학상아이의원구강합면외과행구강암근치병행유리고전외측피판동기수복적1 100례환자(1 132괴),소유환자분위A조(＜60세)781례、B조(≥60세)319례,기록병통계소유환자적위수술구병발증.결과 량조피판총성공솔97.2％(1 100/1 132)[A조97.3％(781/803)、B조97.0％(319/329)],량조차이무통계학의의(P＞0.05);병발증총발생솔27.5％ (302/1 100)[A조25.9％(202/781)、B조31.3％(100/319)],량조차이무통계학의의(P=0.064).다인소분석현시,병발증적발생여미국마취의사협회환자분급(P＜0.001)、수술시간(P=0.021)、환자시부반발질병(P=0.002)유관,이여환자년령무명현상관(P＞0.05).결론 고령병불증가유리고전외측피판일기중건구강암술후결손위수술기병발증;공제수술시간가유효감소위수술기병발증발생.
Objective To identify the factors that were predictive of outcome and to determine the effect of age on perioperative complications.Methods Reviewed the records of 1 100 consecutive patients who underwent anterolateral thigh flap free flap transfers for oral and maxillofacial cancer surgery defects between February 2002 and March 2013.All patients were divided into two groups:A group (＜60 years old) and B group (≥60 years old).Postoperative complications were analyzed from all patients.Results There were 781 cases in A group and 319 in B group.The overall success rate was 97.2％(1 100/l 132)[97.3％ (781/803) in A group,97.0％ (319/329) in B group,P＞0.05].The overall complication rate was 27.5％ (302/1 100)[25.9％ (202/781) in A group,31.3％ (100/319) in B group,P=0.064].Multivariate Cox regression analyses revealed that American Society of Anesthesiologists (ASA) status (P＜0.001),operation time (P=0.021) and comorbidity (P=0.002) were the independent factor for the complication of patients.However,age (P＞0.05) was not an independent factor for the complication of patients.Conclusions Oral and maxillofacial reconstruction using anterolateral thigh flap free flaps in elderly patients can achieve similar outcomes as in younger patients.Controlling operative time is very important in reducing postoperative complications and improving the results of surgery.
