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目的观察并比较舌瓣与颊脂垫瓣在老年颊部缺损修复中的临床效果及预后。方法 60例老年颊部组织缺损患者,按照修复方案不同分成舌瓣组和颊脂垫瓣组,各30例。颊脂垫瓣组采用自体带蒂颊脂垫瓣修复方案,舌瓣组给予舌瓣修复手术,评价两组临床疗效及并发症发生情况。结果颊脂垫瓣组患者术后3周左右出现上皮化和存活,术后3个月已形成正常的口腔黏膜,6个月后移植区与周围的正常区域趋同,无痕迹;舌瓣组术后1周左右舌瓣转为正常红色。颊脂垫瓣组并发症发生率为6.7%,舌瓣组并发症发生率6.7%,比较差异无统计学意义(P>0.05)。颊脂垫瓣组修复总有效率为96.7%,与舌瓣组的93.3%比较差异无统计学意义(P>0.05)。颊脂垫瓣组发音功能改善效果优于舌瓣组,差异具有统计学意义(P<0.05)。结论基于舌瓣与颊脂垫瓣的修复方案对于老年颊部缺损总体疗效相当,手术风险小,建议临床充分评估手术适应证后选择适宜的手术方案。
Objective To observe and compare the clinical effect and prognosis of flap and buccal fat pad in the repair of aged cheek defect. Methods Sixty elderly patients with buccal tissue defects were divided into three groups according to the different rehabilitation plans: flap group and buccal fat pad group. Buccal fat pad flap group with autologous pedicle buccal fat pad flap repair program, the flap group was given flap repair surgery, evaluation of the clinical efficacy and complications of the two groups. Results The buccal fat pad flap group showed epithelialization and survival about 3 weeks after operation. Normal oral mucosa was formed 3 months after operation. The graft area and the surrounding normal area converged with no trace after 6 months. About 1 week after the tongue into normal red. Complication rate of buccal fat pad flap group was 6.7% and complication rate of flap group was 6.7%, with no significant difference (P> 0.05). The total effective rate was 96.7% in the buccal fat pad flap group, and 93.3% in the flap group. There was no significant difference (P> 0.05). Buccal fat pad flap group pronunciation function improved better than the tongue flap group, the difference was statistically significant (P <0.05). Conclusion The repair program based on the flap and buccal fat pad flap has the same overall curative effect on the cheek defect in the elderly and the small operation risk. It is suggested that the appropriate surgical plan should be selected after the clinical indications are fully evaluated.