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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。
Objective To compare the postoperative quality of life of patients with clinically neck negative (cN0) tongue cancer undergoing different reconstruction modalities. Methods Thirty-six patients with tongue cancer undergoing maxillofacial surgery in Guangdong Stomatology Hospital from July 2006 to July 2008 were divided into two groups according to the reconstruction of free flap and the pedicle pectoralis major flap reconstruction. Each group of patients 18 cases. Patients in the free flap reconstruction group underwent suprahyoid neck lymph dissection and the defect of the tongue was repaired with free radial forearm flap or free anterolateral skin flap. Patients with pedicle pectoralis major flap reconstruction received modified radical neck dissection Lymphadenectomy, tongue defects with pedunculated pectoralis major flap repair. At 12 months postoperatively, the quality of life of the two groups was evaluated using a 4-version Washington University Living Quality Questionnaire (UW-QOL). Results The free flap reconstruction group scored better than the Pectoralis major myocutaneous flap reconstruction on total quality of life score, shoulder function, activity, voice and swallowing sub-items. Conclusions For patients with cN0 tongue cancer, the use of scapular supracervical lymphadenectomy and free flap reconstruction can significantly improve the postoperative quality of life of patients with cN0 tongue cancer.