天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (1): 81-83.doi: 10.11958/20170942

• 临床研究 • 上一篇    下一篇

前臂皮瓣与股前外侧皮瓣修复舌癌术后缺损的 供区主观满意度比较

孟丽 1，刘浩 2，沈军 2，穆洁 2，向旭 2，张军 2，彭歆 3，毛驰 3，严颖彬 2△   

  1. 1 天津医科大学（邮编 300070）；2 天津市口腔医院口腔颌面外科；3 北京大学口腔医学院·口腔医院口腔颌面外科
  • 收稿日期:2017-09-04 修回日期:2017-11-14 出版日期:2018-01-15 发布日期:2018-01-16
  • 通讯作者: 孟丽 E-mail:843153290@qq.com
  • 作者简介:孟丽（1989），女，硕士研究生在读，主要从事口腔颌面部肿瘤和创伤研究
  • 基金资助:
    前臂皮瓣与股前外侧皮瓣修复舌癌大型缺损的生存质量比较

Comparison of the subjective satisfaction of free radial forearm flap and anterolateral thigh flap for the donor site after surgical reconstruction in tongue cancer patients

MENG Li1, LIU Hao2, SHEN Jun2, MU Jie2, XIANG Xu2, ZHANG Jun2, PENG Xin3, MAO Chi3, YAN Ying-bin2△   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital; 3 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
  • Received:2017-09-04 Revised:2017-11-14 Published:2018-01-15 Online:2018-01-16
  • Contact: Li MENG E-mail:843153290@qq.com

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摘要： 目的 比较游离前臂皮瓣（FRFF）及股前外侧皮瓣（ALTF）用于舌癌术后缺损重建的供区主观满意度。方 法 选取 2011 年 8 月—2014 年 10 月间在天津市口腔医院和北京大学口腔医院接受 FRFF 或 ALTF 重建的 121 例 原发性舌鳞状细胞癌患者为调查对象。2016 年 10 月—2017 年 1 月间采用自制供区病态特异性问卷评估患者主观 满意度（包括供区感觉、运动障碍、外观、社交活动及生存质量的总体影响 5 个方面）。结果 121 例中有 34 例因肿 瘤或其他疾病死亡，2 例因皮瓣重建术后复发而被剔除，11 例失联，最终 74 例患者完成问卷，FRFF 组 39 例，ALTF 组 35 例。调查结果显示，ALTF 组在供区感觉、外观、对总体生存质量的影响及量表总分均高于 FRFF 组（P < 0.05）。 2 组在运动障碍及社交活动两方面的得分相似（P > 0.05）。结论 ALTF 具有更好的供区病态，对患者总体生存质量 的不良影响较小，满意度较高。

关键词: 舌肿瘤, 显微外科手术, 问卷调查, 病人满意度, 生活质量, 前臂皮瓣, 股前外侧皮瓣, 供区病态

Abstract: Objective To compare the subjective satisfaction of the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) of the donor site after surgical reconstruction for tongue cancer. Methods A total of 121 consecutive patients underwent FRFF or ALTF reconstruction after ablative surgery for untreated, primary tongue squamous cell carcinoma at Tianjin Stomatological Hospital and Peking University School and Hospital of Stomatology from August 2011 to October 2014 were enrolled in this study. The subjective satisfaction of the donor site, including sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life (QOL), was assessed by a self-established donor site morbidity questionnaire from October 2016 to January 2017. Results Of the 121 patients, 34 died because of cancer or other diseases, 2 were excluded because of recurrence after reconstruction surgery, 11 lost to contact, and 74 (61.2%) completed the questionnaires finally, which included 39 patients in FRFF group and 35 patients in ALTF group. The scores for sensibility, cosmetics, general impacts on the QOL and composite score were significantly higher in ALTF group than those of FRFF group (P < 0.05). No significant differences were found in the movement disabilities and social activities between the two groups (P > 0.05). Conclusion ALTF has the advantage of better results of donor site morbidity, less adverse effect on the general QOL, and higher subjective satisfaction.

Key words: tongue neoplasms, microsurgery, questionnaires, patient satisfaction, quality of life, free radial forearm flap, anterolateral thigh flap, donor site morbidity