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目的:分析比较前臂桡侧皮瓣与股前外侧皮瓣在修复半舌缺损后的舌功能恢复和供受区并发症情况。方法:2008年7月~2012年11月,23例舌癌患者接受肿瘤扩大切除,遗留的半舌缺损,14例采用前臂桡侧皮瓣修复,供区伤口取腹部全厚皮片移植修复;9例采用股前外侧皮瓣修复。术后4~6个月,对每例患者的吞咽功能、语言清晰度和供受区并发症等情况进行随访分析。结果:前臂桡侧皮瓣组和股前外侧皮瓣组患者吞咽功能和语言清晰度均恢复良好,两组之间无显著差异。在受区,前臂桡侧皮瓣组有1例出现全部皮瓣坏死;股前外侧皮瓣组有1例出现小部分皮瓣坏死,1例出现口颈瘘。在供区,前臂桡侧皮瓣组有4例出现移植皮片部分坏死,1例伤口部分裂开,12例出现明显的瘢痕,9例局部麻木,3例手臂功能障碍;股前外侧皮瓣组有1例局部麻木,1例出现明显的瘢痕,均未出现运动功能障碍。前臂桡侧皮瓣组供区并发症明显多于股前外侧皮瓣组。结论:股前外侧皮瓣可获得的血管蒂长、管径大、供区并发症少,是半舌缺损较理想的修复组织瓣。
OBJECTIVE: To analyze and compare the recovery of tongue function and the complication of donor area after repairing the half-tongue defect after comparing the radial forearm flap with the anterolateral skin flap. Methods: From July 2008 to November 2012, 23 patients with carcinoma of the tongue underwent extended tumor resection and left half-tongue defect. Fourteen patients were repaired by radial forearm flaps. Nine cases were treated with anterolateral skin flap. Four to six months after operation, follow-up analysis was performed on swallowing function, speech intelligibility and complications for each patient. Results: The swallowing function and speech clarity of the forearm radial flap group and the anterolateral skin flap group recovered well with no significant difference between the two groups. In the affected area, all the skin flap necrosis occurred in 1 case in the forearm radial flap group; in 1 case in the anterolateral skin flap group, a small amount of flap necrosis occurred, and in 1 case, oral and cervical fistula occurred. In the donor site, 4 cases of transplanted skin flap were partially necrotic in the forearm radial flap group, 1 had partial dehiscence, 12 had obvious scar, 9 had local numbness and 3 had arm dysfunction. The anterolateral skin flap There was 1 case of local numbness in the group, 1 case of obvious scarring, no motor dysfunction. Forearm radial skin flap donor area complications were significantly more than the anterolateral skin flap group. Conclusion: The extravascular anterolateral skin flap has longer pedicle length, larger diameter and less complications for the donor area. It is an ideal repair flap for the half-tongue defect.