摘要： 目的：对舌癌患者行舌颈联合根治术，同期行前臂游离皮瓣移植舌再造后，中远期的语音、咀嚼、吞咽等功能恢复情况的观察和初步评价。方法：对我院2008—2013年间，175例行舌（颌）颈联合根治术，同期应用血管化前臂游离皮瓣即时修复舌缺损的患者，按手术切除范围的不同分为3组（I组手术切除≤半舌，II组手术切除舌根或部分舌根，III组手术切除半舌及同侧口底），分别进行2年以上时间的随访。通过语言清晰度测定、咀嚼效率测定、舌运动范围的测量、吞咽造影剂透视显示吞咽模式，对患者修复后的舌形态、运动功能、语言功能、咀嚼功能、吞咽功能等进行评价。结果：本组175例患者语音清晰度良好，但因舌缺损范围的不同，语音清晰度有一定的差别，舌体活动范围III组较其他2组受限明显，而咀嚼效率无明显差异，吞咽功能异常主要表现在启动障碍和造影剂滞留/残留。结论：本研究结果显示前臂皮瓣修复舌缺损，尤其对≤半舌或伴有部分口底缺损的修复，能够获得良好的功能恢复，值得临床继续使用。

关键词: 舌癌,  ,  , 前臂游离皮瓣,  ,  , 功能

Abstract: Objective: To discuss and evaluate the reconstructive outcomes of radial forearm free flaps in the repair of defects after ablative surgery of tongue cancer. Methods: 175 patients with ablative tongue cancer surgery and  reconstructed by radial forearm free flap between 2008 and 2013 were retrospectively reviewed. Patients were divided into three groups according to the scope of surgery. Group Ⅰ, less than half of the resection of the tongue; group Ⅱ, resection the whole tongue or part of the root of tongue; group Ⅲ, resection half of the tongue with ipsilateral mouth floor dissection. The follow-up period continued for more than two years, and the shape of tongue, linguistic function, mastication and deglutition functions after tongue reconstruction were evaluated and compared. Results: All of 175 patients achieved considerable good phonetic intelligibility after tongue repair, but the clarity degree was different between groups. The extent of tongue movement of patients in group Ⅲ was more limited than the other 2 groups. The masticatory efficiency showed no significant difference between three groups. The abnormal swallowing function was mainly manifested in the initiation barrier and contrast agent retention. Conclusion: The results show radial forearm flap  can restore the tongue function effectively, especially the defect is less than or equal to half of the tongue or accompanied by part of the mouth floor.

Key words:  tongue carcinoma, free forearm flap, function

中图分类号: 

• R782.26