以颈横动脉为蒂的两种皮瓣在老年口腔癌术后缺损修复中应用的对比研究

目的:探讨以颈横动脉为蒂的两种皮瓣在修复口腔癌术后缺损的效果。方法:收集2021年3月-2022年3月在我院口腔颌面外科确诊为口腔癌并进行了皮瓣移植修复的39例患者。其中锁骨上动脉皮瓣组15例，上斜方肌皮瓣组24例。观察并记录皮瓣成活情况，供受区形态及功能恢复情况。结果:39例皮瓣总成活率为89.74%(35／39)，锁骨上动脉皮瓣成活率为80.00%(12／15)，上斜方肌皮瓣成活率为95.83%(23／24)，两组皮瓣存活率比较,差异无统计学意义(P>0.05)；在皮瓣特征方面，两组皮瓣的取瓣时间、皮瓣大小、住院时间、修复部位方面比较，差异也无统计学意义(P>0.05)。但是在术后并发症中，锁骨上动脉组在术后感染、瘢痕、色素沉着、功能障碍方面优于上斜方肌皮瓣组，差异具有统计学意义(P<0.05)。术后随访患者6个月，2组皮瓣修复效果良好，两组皮瓣术后生存质量评分比较，差异无统计学意义(P>0.05)。结论:锁骨上动脉皮瓣与上斜方肌皮瓣均可作为修复老年口腔癌术后缺损的可靠皮瓣，但在并发症方面，锁骨上动脉皮瓣要优于上斜方肌皮瓣，能达到更好的效果。

Comparison of two kinds of flaps pedicled with transverse carotid artery for the reconstruction after oral cancer surgery in the elderly patients

Objective:To investigate the effects of two kinds of flaps pedicled with transverse carotid artery for the reconstruction after oral cancer surgery.Methods:From March 2021 to March 2022,39 patients diagnosed with oral cancer by department of oral and maxillofacial surgery of Suining Central Hospital and received flap transplantation were included.There were 15 cases in the superior clavicular artery group and 24 cases in the superior trapezius muscle group.We observed and recorded the ratio of survival flap,as well as the morphological and functional recovery of the donor site.Results:The total survival rate of flaps in 39 patients was 89.74%(35/39).The survival rate in the flap of superior clavicular artery group was 80.00%(12/15) and the survival rate in the flap of superior trapezius muscle group was 95.83%(23/24).There was no significant difference in the survival rate between the two groups (P>0.05).At the same time,there were no significant difference in the flap taking time,flap size,hospital stay and repair part between two groups (P>0.05).However,the postoperative complications such as the infection,scar,pigmentation and dysfunction in the superior clavicular artery group were lower than that in the superior trapezius muscle group (P<0.05).The patients were followed up for 6 months and the patients in the two groups achieved good clinical results.The difference in the scores of QOL post-surgery between the two groups was not statistically significant (P>0.05).Conclusion:Both the superior clavicular artery flap and the superior trapezius muscle flap can be used as reliable flaps for the repair of postoperative ablation in elderly patients with oral cancer.However,in terms of complications,the superior clavicular artery flap is better than the superior trapezius muscle flap.