钛网支架结合前臂游离皮瓣在颌面部肿瘤切除术后软组织缺损修复中的应用

目的:研究钛网支架结合前臂游离皮瓣修复颌面部肿瘤切除术后面部组织缺损的价值。方法:选取笔者医院60例颌面部肿瘤切除术后面部组织缺损修复患者为研究对象,抽签随机分为观察组和对照组,均30例。观察组采取钛网支架结合前臂游离皮瓣进行修复,对照组采取钛网支架结合股前外侧皮瓣进行修复。比较两组患者修复后匹配形态情况(POSAS量表)、面部修复重建疗效(华盛顿大学生存质量评分)和术后并发症发生率及皮瓣存活率。结果:观察组疼痛或瘙痒程度、硬度、厚度以及平整度评分低于对照组,差异有统计学意义(P<0.05),观察组颜色评分与对照组比较差异无统计学意义(P>0.05)。观察组充血程度、厚度及柔软度评分均低于对照组,差异有统计学意义(P<0.05),观察组色泽和顺应度评分与对照组比较差异无统计学意义(P>0.05)。观察组术后张口度和口腔容水量与对照组比较差异无统计学意义(P>0.05),而工作状况、饮食、口腔闭合、咀嚼、咬合、吞咽、语言表达功能的恢复评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症率为6.67%低于对照组26.67%,皮瓣存活率100.00%高于对照组86.67%,差异有统计学意义(P<0.05)。结论:钛网支架结合前臂游离皮瓣修复颌面部肿瘤术后面部组织缺损具有较高价值,能较好地恢复患者的生理功能和面部形态,术后并发症发生率低,皮瓣存活率高,值得临床推广和应用。

The Application of Titanium Mesh Stent Combined with Forearm Free Skin Flap in the Repairing of Soft Tissue Defects after Maxillofacial Tumor Resection

Objective To study the value of titanium mesh stent combined with forearm free skin flap in repairing facial tissue defect after maxillofacial tumor resection. Methods Sixty patients with maxillofacial tumors in our hospital were randomly divided into the observation group and the control group by drawing lots, 30 cases in each group. The observation group was repaired with titanium mesh stent combined with forearm free skin flap, the control group was repaired with titanium mesh stent combined with anterolateral thigh flap. The matching morphology(POSAS scale), the effect of facial reconstruction(quality of life score of Washington University), the incidence of complications and the survival rate of skin flaps were compared between the two groups. Results The pain or itching degree, hardness, thickness and smoothness score of the observation group were lower than those of the control group,the difference were statistically significant(P<0.05), there was no significantly different of the color score between the observation group and the control group(P>0.05).The scores of congestion degree, thickness and softness in the observation group were lower than those in the control group,the difference were statistically significant(P<0.05), there were no significantly different of the color and compliance between the observation group and the control group(P>0.05). There were no significant difference in mouth opening and oral water volume between the two groups(P >0.05), but the recovery scores of working condition, diet, oral closure, mastication, occlusion, swallowing and language expression in the observation group were higher than those in the control group(P <0.05). The complication rate of the observation group was 6.67%,which was lower than that of the control group of 26.67%, the survival rate of the skin flap was 100.00%,which was higher than that of the control group of 86.67%, the differences were statistically significant(P<0.05). Conclusion The titanium mesh stent combined with forearm free skin flap has high value in repairing facial tissue defect after maxillofacial tumor surgery. It can restore the physiological function and facial morphology of patients.the incidence of postoperative complications is low and the survival rate of skin flap is high. It is worthy of clinical promotion and application.