摘要目的 探讨患者年龄对游离股前外侧皮瓣围手术期并发症的影响.方法 回顾2002年2月至2013年3月在中南大学湘雅二医院口腔颌面外科行口腔癌根治并行游离股前外侧皮瓣同期修复的1 100例患者(1 132块),所有患者分为A组(＜60岁)781例、B组(≥60岁)319例,记录并统计所有患者的围手术区并发症.结果 两组皮瓣总成功率97.2％(1 100/1 132)[A组97.3％(781/803)、B组97.0％(319/329)],两组差异无统计学意义(P＞0.05);并发症总发生率27.5％ (302/1 100)[A组25.9％(202/781)、B组31.3％(100/319)],两组差异无统计学意义(P=0.064).多因素分析显示,并发症的发生与美国麻醉医师协会患者分级(P＜0.001)、手术时间(P=0.021)、患者是否伴发疾病(P=0.002)有关,而与患者年龄无明显相关(P＞0.05).结论 高龄并不增加游离股前外侧皮瓣一期重建口腔癌术后缺损围手术期并发症;控制手术时间可有效减少围手术期并发症发生.

abstractsObjective To identify the factors that were predictive of outcome and to determine the effect of age on perioperative complications.Methods Reviewed the records of 1 100 consecutive patients who underwent anterolateral thigh flap free flap transfers for oral and maxillofacial cancer surgery defects between February 2002 and March 2013.All patients were divided into two groups:A group (＜60 years old) and B group (≥60 years old).Postoperative complications were analyzed from all patients.Results There were 781 cases in A group and 319 in B group.The overall success rate was 97.2％(1 100/l 132)[97.3％ (781/803) in A group,97.0％ (319/329) in B group,P＞0.05].The overall complication rate was 27.5％ (302/1 100)[25.9％ (202/781) in A group,31.3％ (100/319) in B group,P=0.064].Multivariate Cox regression analyses revealed that American Society of Anesthesiologists (ASA) status (P＜0.001),operation time (P=0.021) and comorbidity (P=0.002) were the independent factor for the complication of patients.However,age (P＞0.05) was not an independent factor for the complication of patients.Conclusions Oral and maxillofacial reconstruction using anterolateral thigh flap free flaps in elderly patients can achieve similar outcomes as in younger patients.Controlling operative time is very important in reducing postoperative complications and improving the results of surgery.