口腔医学研究

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (3): 230-233.DOI: 10.13701/j.cnki.kqyxyj.2022.03.007

• 口腔颌面外科学研究 • 上一篇    下一篇

评估舌颌颈联合根治患者术中拔牙对口底瘘的影响

范腾飞1,2, 张胜1, 吴汉江1, 吴坤1*   

  1. 1.中南大学湘雅二医院口腔颌面外科 湖南 长沙 410011;
    2.上海交通大学医学院附属九人民医院口腔颌面-头颈肿瘤外科; 上海交通大学口腔医学院国家口腔医学中心; 国家口腔疾病临床医学研究中心; 上海市口腔医学重点实验室 上海 200011
  • 收稿日期:2021-10-09 出版日期:2022-03-28 发布日期:2022-03-25
  • 通讯作者: * 吴坤,E-mail:wukun1302@csu.edu.cn
  • 作者简介:范腾飞(1985~ ),男,博士,湖南长沙人,主治医师,研究方向:口腔癌的基础及临床研究。
  • 基金资助:
    国家自然科学基金青年基金(编号:81802716)湖南省自然科学基金青年基金(编号:2021JJ40877、2020JJ5804)湖南省卫生健康委科研计划课题项目(编号:C2019163)电磁辐射医学防护教育部重点实验室2018年度开放课题(编号:2018DCKF003)

Effect of Tooth Extraction on Fistula Formation in Tongue Cancer Patients Who Underwent Radical Surgery

FAN Tengfei1,2, ZHANG Sheng1, WU Hanjiang1, WU Kun1*   

  1. 1. Department of Oral and Maxillofacial Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China;
    2. Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Received:2021-10-09 Online:2022-03-28 Published:2022-03-25

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摘要： 目的: 评估舌颌颈联合根治患者术中拔牙对口底瘘的影响。方法: 收集我院2017年1月~2020年1月的行舌颌颈联合根治术患者,同期采用股前外侧游离皮瓣修复。依据术中是否拔除下前牙,将患者分为实验组及对照组。实验组为术中离断下颌骨时拔除下前牙,对照组为术中离断下颌骨时不拔除下前牙。结果: 纳入243例舌癌患者,其中男222例,女21例。患者平均年龄(50.38±10.21)岁(范围26~71岁)。其中实验组口底瘘发生率(5.7%)高于对照组(1.5%),但是差异无统计学意义(P>0.05)。通过Logistic回归分析,结果发现吻合静脉数目(P=0.0061)、皮瓣危象(P<0.0001)、术中拔牙(P=0.0049)均与口底瘘的发生密切相关。结论: 在舌颌颈联合根治离断下颌骨保留牙齿,可以预防口底瘘的发生。

关键词: 口底瘘, 舌癌, 拔牙

Abstract: Objective: To evaluate the effect of tooth extraction on fistula formation in tongue cancer patients who underwent radical surgery. Methods: The patients with tongue cancer who underwent radical surgery using an anterolateral thigh flap were recruited from January 2017 to January 2020 in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital. The participants were divided into 2 groups, based on whether the extraction of mandibular anterior teeth was performed with disconnecting mandible. Results: A total of 243 patients with tongue cancer were recruited, of whom 222 were male and 21 were female. The mean age of these patients was (50.38±10.21) years (rang 26 to 71). Although the incidence of experimental group(5.7%)was higher than that of control group(1.5%), no significant differences were found(P>0.05). In the Logistic regression model for the occurrence of fistula, the No. of veins anastomosis(P=0.0061), flap compromise (P<0.0001), and tooth extraction(P=0.0049) were found to be associated with fistula. Conclusion: The reserve of tooth in tongue cancer patients who underwent radical surgery with disconnecting mandible could prevent the occurrence of fistula.

Key words: fistula, tongue cancer, tooth extraction