股前外侧穿支皮瓣修复口腔癌术后缺损患者的生活质量评估

目的 评估应用游离股前外侧穿支皮瓣（ALTF）修复口腔颌面部恶性肿瘤切除术后组织缺损患者的生活质量（QOL）。方法 以2012年1月-2013年7月应用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损的32例患者为研究对象，应用口腔健康影响程度量表（OHIP-14）和简明健康状况调查问卷（SF-36）对患者术后12个月的QOL进行调查和评估。结果 SF-36问卷得分位于前3的项目是躯体疼痛、生理功能和躯体角色，得分分别是78.58±14.82、72.08±27.86和60.00±42.63；得分较低的是情感角色（41.67±39.62）、心理健康（50.75±13.07）和健康变化（54.17±21.75）。分析OHIP-14量表得分，恢复较好的项目是社交障碍和残障，得分分别为34.50±11.32和36.04±12.05；恢复较差的项目是生理性疼痛和心理不适，得分分别为73.50±18.96和60.17±25.66。结论 采用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损，能够恢复患者外形、语言和咀嚼功能的基本需求，提高患者的QOL。

Assessment of the quality of life of oral cancer patients after reconstruction with free anterolateral thigh perforator flaps

Objective This study aims to evaluate the quality of life (QOL) of patients who underwent resection of oral cancer and reconstruction by free anterolateral thigh perforator flaps (ALTF). Methods A total of 32 patients with oral and maxillofacial malignancies who had undergone the resection of oral cancer and reconstruction by ALTF were retrospectively analyzed. At 12 months postoperatively, the QOL of these patients was assessed by using the 14-item oral health impact profile (OHIP-14) and the medical outcome study short form-36 (SF-36) questionnaires. Results A total of 32 questionnaires were collected. In SF-36, the highest scoring domains were bodily pain (78.58±14.82), physical functioning (72.08±27.86), and the role of physical (60.00±42.63), whereas the lowest scoring domains were role-emotional (41.67±39.62), followed by mental health (50.75±13.07) and health transition (54.17±21.75). In OHIP-14, the lowest scoring domains were social disability (34.50±11.32) and handicap (36.04±12.05), indicating the functional recovery was better; and the highest scoring domains were physical pain (73.50±18.96) and psychological discomfort (60.17±20.66), indicating the functional recovery was worse. Conclusion The ALTF is an ideal selection for the reconstruction of oral defects after cancer resection. In using this flap, the basic social need of patients after surgery can be satisfied. Moreover, the appearance and the functions of chewing, deglutition, and speech can be restored in varying degrees. Thus, ALTF can improve the patients’ QOL.