口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后颌面颈部血肿的回顾性研究

doi:10.13701/j.cnki.kqyxyj.2026.01.004

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (1): 17-21.DOI: 10.13701/j.cnki.kqyxyj.2026.01.004

口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后颌面颈部血肿的回顾性研究

曹亚洲¹, 夏成万¹, 柯晓菁^2*

1.南京大学医学院附属口腔医院·南京市口腔医院口腔颌面创伤正颌整形外科南京大学口腔医学研究所江苏南京 210008;
2.南京大学医学院附属口腔医院·南京市口腔医院牙周病科南京大学口腔医学研究所江苏南京 210008

收稿日期:2025-05-06 出版日期:2026-01-28 发布日期:2026-01-23
通讯作者: *柯晓菁,E-mail:shanna90@163.com
作者简介:曹亚洲(1990~ ),男,山东枣庄人,硕士,住院医师,研究方向:口腔颌面外科学。
基金资助:
国家自然科学基金(编号:82403466)

Retrospective Study on Postoperative Maxillofacial and Cervical Hematoma after Reconstruction with Free Flap following Head and Neck Ablative Surgery in Patients with Oral Squamous Cell Carcinoma

CAO Yazhou¹, XIA Chengwan¹, KE Xiaojing^2*

1. Department of Orthognathic Surgery for Oral and Maxillofacial Trauma, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China;
2. Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China

Received:2025-05-06 Online:2026-01-28 Published:2026-01-23

摘要/Abstract

摘要： 目的: 对口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后出现颌面颈部血肿的病例行回顾性分析并探讨相关危险因素。方法: 本研究选取2020年9月~2024年9月行口腔鳞状细胞癌根治性切除联合游离皮瓣修复术的患者239例,其中术后发生血肿并行二次手术20例,分析其临床特点、围手术期相关指标、实验室检查等临床资料。结果: 颌面颈部血肿发生率为8.3%,血肿组与非血肿组的临床分期、淋巴结转移率、手术时长、术中输血率、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)的差异有统计学意义(P＜0.05),多元Logistic回归分析显示术中输血是颌面颈部血肿的独立预测因素。结论: 术中输血可作为预测口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后血肿的风险因素。

关键词: 口腔鳞状细胞癌, 游离皮瓣, 头颈部血肿

Abstract: Objective: To review the associated risk of postoperative hematoma after retrospective analysis on patients with oral squamous cell carcinoma after ablative and reconstructive surgery. Methods: An observational and retrospective analysis of patients with oral squamous cell carcinoma was designed to report the incidence of hematoma in patients undergoing functional neck dissection, radical resection of oral cancer, and repair with free flap in Nanjing Stomoligical Hospital between September 2020 and September 2024. The demographic variables, preoperative laboratory data, and related operative variables were analyzed. Results: A total of 239 patients were finally included, 20 cases had maxillofacial and cervical hematoma, with an incidence rate of 8.3%. There were statistically significant differences in the clinical stage, lymph node metastasis rate, operative time, intraoperative blood transfusion, and activated partial thromboplastin time (APTT) between the hematoma group and the non-hematoma group (P<0.05). Multivariate logistic regression analysis showed that intraoperative blood transfusion was an independent predictor of maxillofacial and cervical hematoma. Conclusion: Intraoperative blood transfusion can serve as an indicator for predicting postoperative hematoma in the maxillofacial and neck regions following radical resection of oral cancer combined with free flap reconstruction.

Key words: oral squamous cell carcinoma, free flap, hematoma

曹亚洲, 夏成万, 柯晓菁. 口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后颌面颈部血肿的回顾性研究[J]. 口腔医学研究, 2026, 42(1): 17-21.

CAO Yazhou, XIA Chengwan, KE Xiaojing. Retrospective Study on Postoperative Maxillofacial and Cervical Hematoma after Reconstruction with Free Flap following Head and Neck Ablative Surgery in Patients with Oral Squamous Cell Carcinoma[J]. Journal of Oral Science Research, 2026, 42(1): 17-21.

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口腔鳞状细胞癌根治性切除联合游离皮瓣修复术后颌面颈部血肿的回顾性研究

Retrospective Study on Postoperative Maxillofacial and Cervical Hematoma after Reconstruction with Free Flap following Head and Neck Ablative Surgery in Patients with Oral Squamous Cell Carcinoma

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