前臂皮瓣修复舌鳞状细胞癌术后舌缺损患者的术后生存质量观察

摘要

Objective To observe the impact of forearm flap restoration and free anterolateral flap restoration on QOL of cN0 stage TSCC patients with tongue defects after surgery .Methods 52 patients with cN0 stage TSCC were chosen and all given modified supra-omohyoid neck dissection(MSOHND) for treatment.Tongue defects were treated respectively with free radial fore-arm flap restoration ( study group ) and free anterolateral thigh flap restoration ( control group ) .12 months after operation ,life quali-ties of patients of the 2 groups were evaluated by UW-QOL.Besides ,depression conditions of the 2 groups were observed .Results UW-QOL showed that,scores of shoulder movement ,deglutition,language,shoulder function and total score of the study group were respectively(68.1 ±19.0),(59.1 ±14.1),(55.5 ±20.3),(57.3 ±27.9)and(897.5 ±65.2),which were obviously higher than those of the control group (84.4 ±18.6),(78.2 ±19.8),(80.1 ±20.4),(89.4 ±16.0)and(754.2 ±101.3)(P<0.05).SAS,SDS and SES scores of the study group were respectively (36.5 ±4.1),(32.9 ±3.0)and(24.5 ±4.1),which were obviously higher than those of the control group (42.0 ±4.2),(39.6 ±4.1)and(18.4 ±3.1)(P<0.05).Conclusion MSOHND and forearm flap restoration for cN 0 stage TSCC can effectively improve postoperative life qualities ,and it is worthy of promotion.%目的：比较前臂皮瓣修复与游离股前外侧皮瓣修复对cN0期舌鳞状细胞癌术后舌缺损患者术后生存质量的影响。方法纳入52例cN0期舌鳞状细胞癌患者，手术方案均为改良肩胛舌骨上颈部淋巴结清扫术（MSOHND），舌部缺损分别采用游离桡侧前臂皮瓣修复（研究组）与游离股前外侧皮瓣修复（对照组）。术后12个月，进行生存质量问卷（ UW-QOL）调查，对两组患者生存质量进行评估。另观察两组患者抑郁情况。结果 UW-QOL评分显示，研究组肩活动、吞咽、语言、肩功能以及总得分分别为（68．1±19．0）、（59．1±14．1）、（55．5±20．3）、（57．3±27．9）、（897．5± 65．2）分，对照组肩活动、吞咽、语言、肩功能以及总得分分别为（84．4±18．6）、（78．2±19．8）、（80．1±20．4）、（89．4± 16．0）、（754．2±101．3）分，上述指标研究组均优于对照组，差异有显著性（P＜0．05）。观察组SAS、SDS、SES评分分别为（36．5±4．1）、（32．9±3．0）、（24．5±4．1）分，对照组SAS、SDS、SES评分分别为（42．0±4．2）、（39．6±4．1）、（18．4± 3．1）分，研究组显著优于对照组（P＜0．05）。结论 cN0期舌鳞状细胞癌患者进行MSOHND及前臂皮瓣修复，能够有效改善患者术后生存质量，值得推广。