摘要
目的：初步探讨前臂桡侧游离皮瓣修复口腔颌面部软组织缺损治疗效果及评价术后语音清晰度的改善。方法：对27例前臂桡侧游离皮瓣及19例胸大肌皮瓣修复口腔颌面部软组织缺损进行临床分析,其中对2例进行主观语音评价。结果：前臂桡侧游离皮瓣修复口腔颌面部各类软组织缺损27例病例中前臂皮瓣存活25例,存活率达92.6%,感染的前臂皮瓣2例,感染率为7.4%,美观满意的患者为25例,满意度为92.6%,平均治疗费3.53万元；19例胸大肌皮瓣中存活17例,存活率达89.4%,感染的有7例,感染率为36.84%,美观满意患者的有为12例,满意度为63.16%,平均治疗费2.56万元。统计分析结果显示两组皮瓣存活率无统计学差异(P>0.05),感染率,患者的满意度及治疗费用有统计学差异(P<0.05),其中本市定期复查,随访资料完整的2例术后进行语音主观评价,平均语音清晰度为70.73%。结论：前臂游离皮瓣具有恒定,制作方便,厚薄适中,血管蒂长,抗感染能力强,恢复美观效果等优点,目前口腔颌面部软组织缺损修复较理想的皮瓣之一,前臂游离皮瓣修复舌部软组织缺损后能够较好地恢复患者的语音功能。
Objectives:To discuss the therapeutic efficacy of radial forearm free flap for oral and maxillofacial lack of soft tissue damage, and to evaluate the post operational improvement of speech intelligibility. Methods:Clinical analysis in 27 cases of radial forearm free flap and 19 cases of pectoral major flap in oral and maxillofacial soft tissue defects were used, and evaluated 2 cases by subjective voice. Results:Among the forearm of free flap 25 flaps survived, the success rate is 92.6%. Two vessel thromboses occurs, but failed after rescue.2 cases of Forearm flap infected, the infection rate was 7.4%, Aesthetic satisfaction of the patients were 25 cases, rate of satisfaction was 92.6%, The average treatment costs was 35,300 Yuan. Pectoral major flap was survived in 17 patients of 19 cases, the survival rate was 89.4%,7 cases was infection, the infection rate was 36.84%, Aesthetic satisfaction of the patients were 12 cases, rate of satisfaction was 63.16%, The average treatment costs was 25,600 Yuan; Statistical analysis showed no significant difference between the survival rate of two groups flap (P> 0.05), Infection rates, patient satisfaction and treatment costs were significantly different (P<0.05), Two cases was regular followed up and accepted the subjective voice evaluation, as a result average speech intelligibility was 70.73%. Conclusions: Radial forearm free flap is steady, easy made, medium thickness, with Long vascular pedicle, It is the ideal flap choice of the oral and maxillofacial soft tissue defections, radial forearm free flap for tongue soft tissue defections considerably recovers patient speech intelligibility.
引文
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