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目的探讨口底鳞状细胞癌术后缺损的修复方法和效果。方法回顾性分析中国医学科学院肿瘤医院1991年1月至2010年12月治疗的69例口底鳞状细胞癌患者的修复方法和效果。结果 69例患者中,采用修复局部或区域皮瓣30例,游离皮瓣20例,游离植皮9例,未修复10例。局部或区域皮瓣部分坏死2例,完全坏死3例,游离皮瓣无坏死。手术后发生口底瘘10例(14.5%),与口底瘘明显相关的因素有皮瓣坏死,用局部或区域皮瓣有较高的口底瘘发生率。结论口底鳞癌手术后缺损时应选用可靠的修复方法,修复失败后口底瘘发生率明显升高,建议多选用游离皮瓣以降低并发症的发生。
Objective To investigate the method and effect of repairing postoperative defect of oral squamous cell carcinoma. Methods Retrospective analysis of 69 cases of squamous cell carcinoma of the mouth treated by Chinese Academy of Medical Sciences Cancer Hospital from January 1991 to December 2010 were performed. Results In 69 patients, there were 30 cases of local or regional flap repair, 20 cases of free flap, 9 cases of free skin graft and 10 cases of no repair. Partial or regional flap partial necrosis in 2 cases, complete necrosis in 3 cases, free flap without necrosis. Fistula occurred after operation in 10 cases (14.5%), and mouth fistula were significantly related to factors such as flap necrosis, with local or regional flap has a higher incidence of fistula. Conclusions Reliable repair should be used after operation for oral squamous cell carcinoma. The incidence of fistula after the failure of repair is obviously increased. It is recommended to use more free flaps to reduce the incidence of complications.