口腔頜面部腫瘤術后游離皮瓣存活的相關因素分析

余曉寧　蔡潔琛

【摘要】 目的：探討影響口腔頜面部腫瘤術后游離皮瓣存活的危險因素，為減少血管危象、提高游離皮瓣術后存活率提供參考。方法：選取2014年1月-2019年1月筆者所在醫院口腔頜面外科收治的208例口腔頜面部腫瘤手術患者為研究對象，依據術后游離皮瓣存活情況將入選患者分為兩組。A組191例，術后游離皮瓣成功存活;B組17例，術后游離皮瓣出現血管危象。收集兩組臨床資料及血生化指標進行比較，Logistic回歸分析影響游離皮瓣存活的危險因素。結果：A組糖尿病4例（23.53%），術前放療4例（23.53%），口腔感染0例，血纖維蛋白原為（2.98±0.36）mg/L，與B組比較差異均有統計學意義（P<0.05）。Logistic回歸分析示，糖尿病、術前放療、口腔感染、血FIB升高是影響口腔頜面部腫瘤術后游離皮瓣存活的獨立危險因素。結論：影響口腔頜面部腫瘤術后游離皮瓣存活的因素眾多，加強術前準備，合理控制血糖，規范術中操作，嚴格遵循無菌化原則，有助于減少血管危象，提高游離皮瓣存活率。

【關鍵詞】 口腔頜面部腫瘤手術; 游離皮瓣; 存活; 血管危象; 危險因素

doi：10.14033/j.cnki.cfmr.2019.19.080 文獻標識碼 B 文章編號 1674-6805（2019）19-0-03

Analysis of Related Factors of Free Flap Survival after Oral and Maxillofacial Tumors/YU Xiaoning，CAI Jiechen.//Chinese and Foreign Medical Research，2019，17（19）：-179

【Abstract】 Objective：To investigate the risk factors of free flap survival after oral and maxillofacial tumor surgery，and to provide reference for reducing vascular crisis and improving the survival rate of free flap.Method：A total of 208 patients with oral and maxillofacial tumors admitted to our hospital from January 2014 to January 2019 were enrolled.The patients were divided into two groups according to the survival of free flaps.In group A，191 patients had successful free flap after operation.In group B，vascular crisis occurred in 17 patients with free flap after operation.The clinical data and blood biochemical indexes of the two groups were collected for comparison.Logistic regression analysis was used to analyze the risk factors affecting the survival of free flaps.Result：In group A，there were 4 cases of diabetes（23.53%），4 cases of preoperative radiotherapy（23.53%），0 case of oral infection，and fibrinogen was （2.98±0.36）mg/L，and compared with the group B，the differences were statistically significant（P<0.05）.Logistic regression analysis showed that hyperglycemia，preoperative radiotherapy，oral infection and elevated blood FIB were independent risk factors for the survival of free flap after oral and maxillofacial tumor surgery.Conclusion：There are many factors influencing the survival of free flap after oral and maxillofacial tumor surgery.Strengthen preoperative preparation，rationally control blood sugar，standardize intraoperative operation，strictly follow the principle of aseptic，help reduce vascular crisis and improve the survival rate of free flap.

【Key words】 Oral and maxillofacial tumor surgery; Free flap; Survival; Vascular crisis; Risk factors

First-authors address：Huizhou First Peoples Hospital，Huizhou 516000，China