游离股前外侧皮瓣与游离前臂皮瓣对颊部肿瘤切除后缺损修复的疗效研究

Observation on the repair effect of free anterolateral thigh flap and free forearm flap on defects after buccal tumor resection

摘要:

目的 探究游离股前外侧皮瓣与游离前臂皮瓣对颊部肿瘤切除后缺损修复的效果。方法 选取2020年8月—2023年8月三二〇一医院70例对颊部肿瘤切除后缺损进行修复的患者作为研究对象，根据不同手术方法分为股前外侧组与前臂组，各35例。股前外侧组采用游离股前外侧皮瓣修复；前臂组则采用游离前臂皮瓣修复。比较两组患者的一般资料，术后3个月的张口度、咀嚼、吞咽功能及美观效果，术后6个月的生活质量，以及术后并发症发生情况。结果 股前外侧组与前臂组性别、年龄、缺损面积、病灶位置、病理类型及临床分期比较，差异均无统计学意义（P >0.05）。股前外侧组张口度大于前臂组（P <0.05）。股前外侧组与前臂组咀嚼功能分级、吞咽功能分级和美观效果比较，差异均无统计学意义（P >0.05）。股前外侧组与前臂组生理机能、社会功能、情感职能、精神健康、精力、躯体健康和生理职能评分比较，差异均无统计学意义（P >0.05）；股前外侧组一般健康状况评分高于前臂组（P <0.05）。股前外侧组瘢痕增生率、供区坏死率、受区麻木率、色素沉着率、受区感觉异常率、瘙痒率、暂时性功能障碍率和永久性功能障碍率均低于前臂组（P <0.05）。结论 在颊部肿瘤切除术后缺损修复的治疗中，应用股前外侧皮瓣和前臂皮瓣均可取得较好效果，恢复并维持患者的咀嚼、吞咽功能，保证患者的生活质量，但选择股前外侧皮瓣进行修复的术后并发症明显更少。

Abstract:

Objective To explore the repair effect of free anterolateral thigh flap and free forearm flap on defects after buccal tumor resection.Methods A total of 70 patients who underwent defect repair after buccal tumor resection at 3201 Hospital from August 2020 to August 2023 were selected as the research subjects, and divided into an anterolateral thigh group and a forearm group according to the surgical methods, with 35 cases in each group. The anterolateral thigh group was repaired with free anterolateral thigh flap, while the forearm group was repaired with free forearm flap. The general data, mouth opening degree, chewing function, swallowing function, aesthetic effect at 3 months after operation, quality of life at 6 months after operation, and the occurrence of postoperative complications were compared between the two groups.Results There were no statistically significant differences in gender, age, defect area, lesion location, pathological type, and clinical stage between the anterolateral thigh group and the forearm group (P > 0.05). The mouth opening degree of the anterolateral thigh group was larger than that of the forearm group (P < 0.05). There were no statistically significant differences in masticatory function grading, swallowing function grading, and aesthetic effect between the anterolateral thigh group and the forearm group (P > 0.05). There were no statistically significant differences in scores of physiological function, social function, emotional role, mental health, vitality, physical health, and physiological role between the anterolateral thigh group and the forearm group (P > 0.05); the general health status score of the anterolateral thigh group was higher than that of the forearm group (P < 0.05). The rates of scar hyperplasia, donor site necrosis, recipient site numbness, pigmentation, recipient site sensory abnormality, pruritus, temporary dysfunction, and permanent dysfunction in the anterolateral thigh group were all lower than those in the forearm group (P < 0.05).Conclusion In the repair of defects after buccal tumor resection, both free anterolateral thigh flap and free forearm flap can achieve good results, restore and maintain the patient's chewing and swallowing functions, and ensure the patient's quality of life. However, the use of free anterolateral thigh flap for repair results in significantly fewer postoperative complications.