中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (2): 152-157.doi: 10.19438/j.cjoms.2023.02.009

• 论著 • 上一篇    下一篇

超声刀在辅助制备游离腓骨肌皮瓣中的临床应用

胡潇丹1,2, 徐豪越1,2, 李晓1,2, 卜令学1,2, 贾暮云1,2, 袁荣涛3, 庞宝兴1,2   

  1. 1.青岛大学附属医院 口腔颌面外科,山东 青岛 266003;
    2.青岛大学 口腔医学院,山东 青岛 266003;
    3.青岛市市立医院 口腔医学中心,山东 青岛 266071
  • 收稿日期:2022-10-05 修回日期:2022-11-23 出版日期:2023-03-20 发布日期:2023-06-12
  • 通讯作者: 庞宝兴,E-mail：baoxingpang@qdu.edu.cn
  • 作者简介:胡潇丹（1998-）,女,在读硕士研究生,E-mail: 2017210457@qdu.edu.cn
  • 基金资助:
    山东省自然科学基金（ZR2017BH034）

Clinical application of ultrasonic scalpel in the preparation of fibular osteomyocutaneous free flap

HU Xiao-dan1,2, XU Hao-yue1,2, LI Xiao1,2, BU Ling-xue1,2, JIA Mu-yun1,2, YUAN Rong-tao3, PANG Bao-xing1,2   

  1. 1. Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao University, Qingdao University. Qingdao 266003;
    2. School of Stomatology of Qingdao University. Qingdao 288003;
    3. Qingdao Municipal Hospital, Affiliated to Shandong University. Qingdao 266071, Shandong Province, China
  • Received:2022-10-05 Revised:2022-11-23 Online:2023-03-20 Published:2023-06-12

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摘要： 目的： 探讨超声刀在辅助制备游离腓骨肌皮瓣中的可行性和实用性。方法： 收集 2019年9月—2022年3月就诊于青岛大学附属医院口腔颌面外科需行游离腓骨肌皮瓣修复头颈部缺损的患者62例。其中,实验组采用超声刀辅助制备游离腓骨肌皮瓣（n=30）,对照组采用传统单极电刀制备游离腓骨肌皮瓣（n=32）。比较2组患者的腓骨肌皮瓣制备时间、术中总失血量、腓骨供区失血量、腓骨供区引流量、腓骨供区引流天数等手术相关指标,以及术后引流液中肿瘤坏死因子（TNF-α）、白细胞介素6（IL-6）水平,术后并发症（出血、水肿、皮瓣坏死）和术后腓骨供区的疼痛评分。采用 SPSS 25.0 软件包对数据进行统计学分析。结果： 实验组腓骨供区失血量显著降低（P<0.01）,腓骨肌皮瓣制备时间、术中总失血量、腓骨供区引流量、腓骨供区引流天数显著减少（P<0.05）。实验组术后引流液中TNF-α及IL-6水平显著下降（P<0.01）。2组术后并发症无统计学差异（P>0.05）。2组患者腓骨供区术后第1天疼痛评分无显著差异（P>0.05）,但实验组腓骨供区术后2~5天的疼痛评分显著降低（P<0.05）。结论： 超声刀辅助制备游离腓骨肌皮瓣较传统单极电刀损伤更小,患者术后恢复更好,术中采用超声刀止血在口腔修复重建外科中具有良好的临床应用前景。

关键词: 超声刀, 游离腓骨肌皮瓣, 修复重建

Abstract: PURPOSE: To explore the feasibility and practicability of ultrasonic scalpel in the preparation of fibular osteomyocutaneous free flap. METHODS: From September 2019 to March 2022, 62 patients who needed fibular osteomyocutaneous free flap to repair head and neck defects in the Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao University were collected. In the experimental group, fibular osteomyocutaneous free flaps were prepared by ultrasonic scalpel(n=30); while in the control group, fibular osteomyocutaneous free flaps were prepared by traditional monopolar electrotome(n=32). The preparation time of fibular osteomyocutaneous free flap, total intraoperative blood loss, blood loss of fibular donor site, drainage volume of fibular donor site, drainage days of fibular donor site and other surgery-related indexes were compared. The levels of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) in the postoperative drainage fluid were also compared. At the same time, postoperative complications (bleeding, edema, flap necrosis) and postoperative fibula donor site pain score were compared. SPSS 25.0 software package was used for statistical analysis. RESULTS: In the experimental group, the blood loss from fibular donor site was significantly decreased(P<0.01), and the preparation time of fibular osteomyocutaneous free flap, the total intraoperative blood loss, the drainage volume of fibular donor site, and the drainage days of fibular donor site were significantly decreased(P<0.05). The levels of TNF-α and IL-6 in the drainage fluid of the experimental group were significantly decreased(P<0.01). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). In addition, there was no significant difference in the pain score of the fibular donor site on the first day after operation between the two groups(P> 0.05), but the pain score of the fibular donor site in the experimental group was significantly decreased from the second day to the fifth day after operation(P<0.05). CONCLUSIONS: The preparation of fibular osteomyocutaneous free flap assisted by ultrasonic scalpel has less damage and better postoperative recovery for patients than traditional monopolar electrotome. Hemostasis with ultrasonic scalpel during operation has a good clinical application prospect in oral reconstructive surgery.

Key words: Ultrasonic scalpel, Fibular osteomyocutaneous free flap, Reconstruction

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