带蒂锁骨上动脉皮瓣与胸大肌肌皮瓣在口腔癌术后缺损修复中的对比研究

摘要

Objective To compare the pedicled supraclavicular artery island flap (SCAIF) and the pectoralis major myocutaneous flap (PMMF) for oral reconstruction after cancer resection.Methods This is a retrospective study from May 2007 to May 2017.Sixty-one patients from the Jiangxi University of Traditional Chinese Medicine and the First Affiliated Hospital of Nanchang University,were included.All the patients underwent oral squamous cell carcinoma resection and pedicled flap reconstruction.Sixteen patients were performed SCAIFs (group A),and 45 were performed PMMFs (group B).The flap survival rate,flap size,flap preparation time,the presence of scar hyperplasia,pigmentation and dysfunction (temporary or permanent) were compared between these two groups.Results The survival rate of flaps in group A was 93.75％ (15/16),and the survival rate of flaps in group B was 95.56％ (43/45).There was no statistically significant difference in the survival rate of flaps,the average skin flap size or flap produce time between these 2 groups.There were no scar hyperplasia,pigmentation and dysfunction was observed in group A.However,scar hyperplasia (n =11),pigmentation (n =10) and dysfunction (n =12) occurred in group B.The difference was statistically significant (P＜ 0.05).Conclusions This study suggests that SCAIF is more reliable,and brings more satisfied outcome,when compared with the PMMF.%目的 比较带蒂锁骨上动脉皮瓣与胸大肌肌皮瓣在口腔癌术后缺损修复中的差异.方法 回顾分析2007年5月至2017年5月江西中医药大学附属医院和南昌大学第一附属医院口腔科收治的61例行带蒂皮瓣修复口腔癌的患者资料,其中采用带蒂锁骨上动脉皮瓣修复16例(A组),胸大肌肌皮瓣修复45例(B组),比较2组皮瓣成活率、皮瓣面积、皮瓣制取时间,以及是否存在瘢痕增生、色素沉着、功能障碍(暂时性或永久性)等情况的差异.结果 A组皮瓣成活率93.75％(15/16),B组皮瓣成活率95.56％(43/45),差异无统计学意义(P＞0.05);2组皮瓣面积、皮瓣制备时间差异无统计学意义(P＞0.05).A组瘢痕增生0例、色素沉着0例、功能障碍0例;B组瘢痕增生11例、色素沉着10例、功能障碍12例,差异均具有统计学意义(P＜0.05).结论 带蒂锁骨上动脉皮瓣和胸大肌肌皮瓣均可用于口腔癌术后缺损修复,但带蒂锁骨上动脉皮瓣较胸大肌肌皮瓣能达到更好的效果.