中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (12): 1026-1030.doi: 10.19401/j.cnki.1007-3639.2020.12.010

• 论著 • 上一篇    下一篇

修复口腔癌术后缺损的股前外侧皮瓣供区积液的临床分析

张 磊 1,2 ,李 欣 1 ,秦兴军 1 ,王 良 1 ,郭 兵 1 ,于 淼 3 ,徐立群 1   

  1. 1. 上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面 - 头颈肿瘤科,国家口腔疾病临床
    医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011 ;
    2. 山东省济宁医学院附属医院口腔颌面外科,山东 济宁,272000 ;
    3. 上海交通大学医学院附属第九人民医院·口腔医学院口腔第二门诊部,国家口腔疾病临床医学研
    究中心,上海市口腔医学重点实验室 , 上海市口腔医学研究所,上海 201900
  • 出版日期:2020-12-30 发布日期:2021-01-08
  • 通信作者: 于 淼 E-mail: feifei09033@126.com

A clinical study of donor site effusion in patients with oral cancer after anterolateral thigh flap repair

ZHANG Lei 1, 2 , LI Xin 1 , QIN Xingjun 1 , WANG Liang 1 , GUO Bing 1 , YU Miao 3 , XU Liqun 1#br#   

  1. 1.Department of Oral & Maxillofacial Head & Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China; 2. Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jining Medical College, Jining 272000, Shandong Province, China; 3. 2nd Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 201900, China

  • Published:2020-12-30 Online:2021-01-08
  • Contact: YU Miao E-mail: feifei09033@126.com

摘要: 背景与目的:股前外侧皮瓣(anterolateral thigh flap,ALTF)是口腔癌术后修复最常用的皮瓣。通过回顾分析口腔癌手术病例,探讨如何最大限度地降低ALTF制备术后供区积液的发生率。方法:选择2018年4月—2018年12月于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科住院的病例,共149例,根据ALTF制备及供区处理方式的不同,分为3组:第1组,大腿阔筋膜上制备ALTF(阔筋膜上ALTF)37例,关创时将阔筋膜对位缝合,术后大腿供区未行加压包扎;第2组,大腿阔筋膜下制备ALTF(阔筋膜下ALTF)66例,术后因阔筋膜缺损多、张力过大,不能拉拢缝合,术后大腿供区配合绷带加压包扎;第3组,大腿阔筋膜下制备ALTF 46例,术后阔筋膜缺损多、张力过大,不能拉拢缝合,术后大腿供区未行绷带加压包扎。术后随访1个月,观察大腿供区积液发生情况。结果:大腿供区术后积液总的发生率为10.07%,其中第1组积液发生率为0.00%,第2组积液发生率为10.61%,第3组积液发生率为17.39%,各组间比较差异有统计学意义(P<0.05)。结论:大腿阔筋膜上制备ALTF较阔筋膜下制备ALTF的供区处理方式能够有效降低供区术后积液的发生率。对已制备阔筋膜下ALTF的病例,对大腿供区进行加压包扎,可起到降低供区积液发生率的作用。

关键词: 口腔癌, 股前外侧皮瓣, 大腿供区, 积液

Abstract: Background and purpose: Anterolateral thigh flap (ALTF) is the most commonly used flap for oral cancer surgery. This study aimed to retrospectively analyze the information of oral cancer patients and to explore how to minimize the incidence of effusion in the donor site. Methods: This study included 149 patients who underwent surgery in Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from Apr. 2018 to Dec. 2018. According to the different methods of preparing and processing the ALTF, we divided these patients into three groups. In the first group, 37 patients were prepared with ALTF upon the fascia lata, the fascia lata was sutured, and the thigh was not bandaged after surgery. In the second group, 66 patients were prepared with ALTF below the fascia lata. Because all these patients had relatively large tissue defect, the fascia lata could not be sutured completely. After surgery, thigh was bandaged in all these patients. In the third group, 46 patients were prepared with ALTF below the fascia lata. The fascia lata was not sutured without pressure bandage. One month after surgery, we followed up the occurrence of effusion in the donor site. Results: The overall incidence of postoperative effusion in the thigh donor site was 10.07%. No one in the first group had effusion, and the incidence of effusion in the second group and the third group was 10.61% and 17.39%, respectively. There were statistically significant differences among these three groups (P<0.05). Conclusion: The preparation of ALTF upon the fascia lata is less prone to effusion than the preparation of ALFT below the fascia lata. Furthermore, bandaging the donor area of the thigh after surgery can also reduce the incidence of effusion.

Key words: Oral cancer, Anterolateral thigh flap, Thigh donor area, Effusion