颊脂垫瓣在腭部肿瘤切除术后缺损修复中的应用

摘要

Objective To study the application effect of buccal fat pad flap in the patients with defect repair af-ter palate tumor excision,and to investigate the influence on the traumatic stress of patients.Methods Sixty patients with defect repair after palate tumor excision in Department of Stomatology,the Second People's Hospital of Panzhihua from March 2013 to February 2016 were selected as the study objects,which were randomly divided into control group (treated with antebrachial flap)and observation group(treated with buccal fat pad flap)according to random number ta-ble,with 30 patients in each group.Then the pronunciation situation and maximal mouth opening before treatment and at 1 month,2,3 months after treatment were compared between the two groups,as well as serum expression levels of trau-matic stress indexes including β-endorphin (β-EP), heat-shock protein (HSP-70), interleukin-6 (IL-6) and cortisol (Cor)before treatment and at 1 d,5 d,10 d after treatment.Results The pronunciation situation,maximal mouth open-ing,and serum expression levels of traumatic stress indexes of two groups showed no statistically significant difference before treatment (all P>0.05). The normal rates of pronunciation at 1 month, 2 and 3 months after treatment were 33.33%,43.33% and 53.33% in the observation group,significantly higher than 10.00%,13.33% and 16.67% in control group (P<0.05). The normal rates of maximal mouth opening were 86.67%, 93.33% and 96.67% in the observation group,significantly higher than 53.33%,63.33% and 70.00% in the control group.The β-EP,HSP-70,IL-6 and Cor lev-els at 1 d,5 d,10 d after treatment in the observation group were all significantly lower than those of control group(P<0.05).Conclusion The effect of buccal fat pad flap in the patients with defect repair after palate tumor excision is better, as compared with antebrachial flap,which has better influence on the oral function state and traumatic stress of patients.%目的 观察颊脂垫瓣在腭部肿瘤切除术后缺损修复中的应用效果,并探讨其对患者创伤应激的影响.方法 选取2013年3月至2016年2月期间攀枝花市第二人民医院口腔科收治的60例腭部肿瘤切除术后缺损修复患者为研究对象,根据随机数表法分为对照组(前臂皮瓣组)和观察组(颊脂垫瓣组),每组30例,比较两组患者治疗前及治疗后1个月、2个月、3个月的发音情况及张口度,治疗前及治疗后1d、5d、10d创伤应激指标[β-内啡肽(β-EP)、热休克蛋白70(HSP-70)、白介素6(IL-6)及皮质醇(Cor)]在血清中的表达水平.结果 治疗前两组患者的发音情况、张口度及创伤应激指标血清表达水平比较,差异均无统计学意义(P>0.05);治疗后1个月、2个月及3个月,观察组患者的发音正常率分别为33.33%、43.33%及53.33%,均明显高于对照组的10.00%、13.33%及16.67%,张口度正常率为86.67%、93.33%及96.67%,均明显高于对照组的53.33%、63.33%及70.00%,差异均有统计学意义(P<0.05);治疗后1 d、5 d及10 d,观察组患者的β-EP、HSP-70、IL-6及Cor血清表达水平均明显低于对照组,差异均有统计学意义(P<0.05).结论 颊脂垫瓣在腭部肿瘤切除术后缺损修复中的效果较好,对患者的口腔功能状态及创伤应激的影响更好,更为适用于腭部肿瘤切除术后缺损修复的患者.