前臂游离皮瓣和股前外侧游离皮瓣在头颈部恶性肿瘤切除术后缺损修复中的应用

Application of forearm free flap and anterolateral thigh free flap for repairing the postoperative defects of head and neck malignant tumor

摘要:

目的 比较前臂游离皮瓣与股前外侧游离皮瓣修复头颈部恶性肿瘤术后缺损患者的恢复情况。方法 选取2019年1月—2022年12月接受治疗的头颈部恶性肿瘤术后软组织缺损患者40例，按随机数字表法分为前臂组与股前外组，分别采用前臂游离皮瓣和股前外侧游离皮瓣修复。对比两组皮瓣成活率、并发症发生率及其他手术相关情况。结果 两组皮瓣成活率、皮瓣制备时间、手术时间、ICU留观时间、术后住院时间的差别无统计学意义(P>0.05)；两组术后并发症的发生率，前臂组明显多于股前外组，差别具有统计学意义(P<0.05)。结论 前臂游离皮瓣和股前外侧游离皮瓣均有良好的皮瓣存活率(95%)，均能较好地修复头颈部恶性肿瘤术后软组织缺损。临床使用中各有优势，需根据具体情况做出最佳选择。

Abstract:

Objective To compare the application effect of forearm free flap and anterolateral thigh free flap in repairing the postoperative defects of head and neck carcinoma. Methods Forty patients were divided into the forearm free flap group and the anterolateral thigh free flap group according to the random number table method, who had soft tissue defects after the patients received treatment of head and neck squamous cell carcinoma surgery from January 2019 to December 2022. One group was repaired by forearm free flap, and the other group by anterolateral thigh free flap. The survival rate of flaps, the incidence of complications and other surgery-related conditions were compared between the two groups. Results There was no statistically significant difference in the survival rate of flaps, flap preparation time, operation time, ICU observation time, and postoperative hospital stay between the two groups (P>0.05).The incidence of postoperative complications in forearm free flap was higher than that in the anterolateral thigh free flap group.The difference was statistically significant (P<0.05). Conclusions Both forearm free flap and anterolateral thigh free flap have good flap survival rate(95%)，which are prior choices for repairing the soft tissue defects after surgery for head and neck squamous cell carcinoma. There are individual advantages for both in clinical practices ,the selection of appropriate flap repair should be made according to the specific situations of patients and doctors.