口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (5): 474-478.DOI: 10.13701/j.cnki.kqyxyj.2021.05.019

• 口腔颌面外科学研究 • 上一篇    下一篇

不同皮瓣修复重建术对口腔颌面软组织缺损病人恢复情况及SA、sIL-2R水平的影响

韩晓东1, 陈东晖2*, 赵芙蓉1   

  1. 1.青海省人民医院颌面外科 青海 西宁 810007;
    2.青海省人民医院病案科 青海 西宁 810007
  • 收稿日期:2020-06-04 发布日期:2021-05-17
  • 通讯作者: * 陈东晖,E-mail:maoniu1050@163.com
  • 作者简介:韩晓东(1986~ ),男,青海西宁人,学士,主治医师,主要从事面部美容手术、注射美容。

Effects of Different Skin Flaps on Recovery and SA and sIL-2R Levels in Patients with Oral and Maxillofacial Soft Tissue Defects

HAN Xiaodong1, CHEN Donghui2*, ZHAO Furong1   

  1. 1. Department of Oral and Maxillofacial Surgery, Qinghai Provincial People's Hospital, Xining 810007, China;
    2. Medical Record Department, Qinghai Provincial People's Hospital, Xining 810007, China
  • Received:2020-06-04 Published:2021-05-17

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摘要： 目的:探讨不同皮瓣修复重建术对口腔颌面软组织缺损病人恢复情况及血清唾液酸(sialic acid,SA)、可溶性白细胞介素-2受体(soluble interleukin-2 receptor,sIL-2R)水平的影响。方法:选取青海省人民医院于2015年1月~2017年1月收治的66例口腔颌面软组织缺损患者为研究对象,采取传统股前外侧皮瓣修复治疗、带股外侧皮神经游离股前外侧皮瓣修复治疗以及前臂皮瓣修复治疗者各22例,设为A、B、C组。比较3组患者术后随访6个月的功能恢复情况、患者满意度以及血清SA、sIL-2R表达水平,同时记录各组患者口腔不良状况发生情况。结果:术后随访6个月,一次皮瓣种植成活率为96.97%;B组患者外形修复、张口度、闭合情况、进食情况、语言功能、吞咽功能、咀嚼功能、咬合功能等评分显著优于A组和C组(P<0.001或P<0.05);且B组患者术后感觉优良率以及满意度高于A组和C组(P<0.05)。术后1个月,B组下降程度优于A组和C组,A组下降程度由于C组(P<0.05)。与C组患者相比,B组患者各并发症发生率均降低(P<0.05);与A组相比,B组患者感觉异常、反应迟钝发生率降低(P<0.05)。结论:游离股前外侧皮瓣术修复口腔颌面软组织缺损的皮肤修复重建效果最佳,有利于降低供区并发症发生风险和改善患者功能,且安全性良好,值得临床推广应用。

关键词: 口腔颌面软组织缺损, 股前外侧皮瓣, 股外侧皮神经, 唾液酸, 前臂皮瓣修复, 可溶性白细胞介素-2受体

Abstract: Objective: To explore the effects of different skin flaps on the recovery and sialic acid (SA) and soluble interleukin-2 receptor (sIL-2R) levels in patients with oral and maxillofacial soft tissue defects. Methods: Sixty-six patients with oral and maxillofacial soft tissue defects treated in Qinghai Provincial People's Hospital from January 2015 to January 2017 were selected as the research subjects. They were randomly divided into three groups (A, B, and C) with 22 cases in each group. Group A was treated with traditional anterolateral femoral flap, group B was treated with lateral femoral cutaneous nerve free anterolateral femoral flap, and group C was treated with forearm flap. The functional recovery of patients after 6 months of follow-up was compared, and patient satisfaction, serum SA, sIL-2R expression levels, and the incidence of oral adverse conditions in each group of patients were recorded and compared. Results: After 6 months of follow-up, the survival rate of flap was 96.97%. The scores of shape repair, mouth opening, closure, eating, language function, swallowing function, chewing function, and occlusal function of group B were significantly better than those of group A and group C (P<0.001 or P<0.05). And the postoperative sensory excellent rate and satisfaction of group B were higher than those of group A and group C (P<0.05). One month after surgery, the decrease in group B was better than those in groups A and C. The decrease in group A was better than that in group C (P<0.05). Compared with patients in group C, the incidence of complications in group B was reduced (P<0.05). Compared with patients in group A, the incidence of paresthesia and unresponsiveness in group B was reduced (P<0.05). Conclusion: The free anterolateral femoral skin flap is the best treatment for skin repair and reconstruction of oral and maxillofacial soft tissue defects, which is conducive to reduce the risk of donor site complications and improve the patient's functional recovery

Key words: oral and maxillofacial soft tissue defect, anterolateral femoral skin flap, lateral femoral cutaneous nerve, sialic acid, forearm flap repair, soluble interleukin-2 receptor