中国实用口腔科杂志

中国实用口腔科杂志 ›› 2011, Vol. 4 ›› Issue (08): 472-474.

• 论著 • 上一篇    下一篇

不同重建方式对临床颈部阴性舌癌患者术后生存质量影响研究

  

  1. 广东省口腔医院· 南方医科大学附属口腔医院口腔颌面外科， 广州  510280
  • 收稿日期:2011-06-08 修回日期:2011-07-30 出版日期:2011-08-15 发布日期:2011-09-07

  • Received:2011-06-08 Revised:2011-07-30 Online:2011-08-15 Published:2011-09-07

摘要：

目的    比较接受不同重建方式的临床颈部阴性（cN0）舌癌患者的术后生存质量。方法    将2006年7月至2008年7月在广东省口腔医院颌面外科治疗的舌癌患者36例，按游离皮瓣重建、带蒂胸大肌皮瓣重建方式分为两组，每组患者18例。游离皮瓣重建组患者接受肩胛舌骨上颈淋巴清扫术，舌部缺损采用游离桡侧前臂皮瓣或游离股前外侧皮瓣修复；带蒂胸大肌皮瓣重建组患者接受改良根治性颈淋巴清扫术，舌部缺损采用带蒂胸大肌皮瓣修复。术后12个月，采用4版华盛顿大学生存质量问卷（UW-QOL）对两组患者的生存质量进行评价。结果        游离皮瓣重建组在生存质量总分及肩功能、活动、语音、吞咽分项目上得分均优于胸大肌皮瓣重建组。结论    对于cN0舌癌患者，采用肩胛舌骨上颈淋巴清扫术和游离皮瓣重建能显著提高患者的术后生存质量。

关键词: 舌鳞癌, 生存质量, 颈淋巴清扫, 重建

Abstract:

Objective    To compare the quality of life of patients with oral squamous cell carcinoma of clinical negative neck after two types of neck dissection and tongue defects reconstruction. Methods    Between July 2006 and July 2008， 36 patients with tongue squamous cell carcinoma treated at Department of Oral and Maxillofacial Surgery，Guangdong Provincial Stomatological Hospital were divided into two groups：18 cases underwent supraomohyoid neck dissection （SOND） and tongue defects reconstruction with free flaps； the other 18 cases received modified radical neck dissetion （MRND） and tongue defects reconstruction with major pectoral muscle flaps. The quality of life was evaluated at least 12 months after surgery using University of Washington Quality of Life Questionnaire （version 4.0）. Results    The group undergoing SOND and free flaps reconstruction got higher scores not only in domains of activity， deglutition， speech and shoulder function but also in total score of quality of life than the other group. Conclusion    SOND combined with free flaps reconstruction can improve the postoperative quality of life of patients with tongue squamous cell carcinoma of clinical negative neck.

Key words: tongue squamous cell carcinoma； quality of life； neck dissection； reconstruction