摘要
目的 分析鼻饲管对股前外侧游离皮瓣修复口腔癌缺损的患者术后情况影响。方法 选取2020年1月至2022年12月120例湖南省人民医院收治的口腔癌患者作为观察对象。所有患者均采用大腿股前外侧游离皮瓣进行修复，并观察术后使用或不使用鼻饲管患者并发症发生情况，如：代谢紊乱、营养不良、口腔感染、肺部感染发生情况，同时比较患者口腔发音功能、温感功能评分。结果 与非鼻饲管患者相比，鼻饲管组患者的并发症总发生率降低（P<0.05）。与非鼻饲管患者相比，鼻饲管组患者的口腔发音功能评分无统计学意义（P>0.05）。与非鼻饲管患者相比，鼻饲管组患者的口腔温感功能评分无统计学意义（P>0.05）。结论 术后使用鼻饲管对股前外侧皮瓣移植在口腔癌患者中具有较好的应用效果，能够降低患者的并发症总发生率，值得在临床上使用。
关键词： 口腔癌；股前外侧游离皮瓣；鼻饲管进食；经口进食
Abstract
Objective To analyze the effect of nasogastric tube on the postoperative condition of patients with oral cancer defect repaired by anterolateral thigh free flap. Methods A total of 120 patients with oral cancer admitted to Hunan Provincial People's Hospital from January 2020 to December 2022 were selected as the observation objects. All patients were repaired with anterolateral thigh free flap. To observe the postoperative complications, such as metabolic disorders, malnutrition, oral infections and lung infections, in patients with or without nasal feeding tube. The scores of oral pronunciation function and temperature sensing function were compared. Results Compared with non-nasogastric tube patients, the complication rate in nasogastric tube group was lower (P<0.05). Compared with non-feeding tube patients, there was no statistical significance in oral pronunciation function scores in the feeding tube group (P>0.05). Compared with non-nasogastric tube patients, there was no statistical significance in oral temperature sensing function scores in nasogastric tube group (P>0.05). Conclusion The anterolateral thigh free flap transplantation with nasogastric tube after operation has a good application effect in patients with oral cancer. It can reduce the complication rate of patients and is worthy of clinical use.
Key words： Carcinoma of mouth; Anterolateral thigh free flap; Nasogastric tube feeding; Oral feeding
参考文献 References
[1] 李菊, 王振国, 罗业姣, 贾颖, 董秀华, 龚仁国, et al. 金雀异黄酮对口腔癌体外放射治疗的有效性研究. 成都医学院学报. 2023;18(04):421-5.
[2] Rivera C. Essentials of oral cancer. International journal of clinical and experimental pathology. 2015;8(9).
[3] 朱伟. 个性化营养支持对改善口腔癌术后患者营养状况的影响. 当代护士(中旬刊). 2019;26(04):60-2.
[4] 陈李鑫. 聚多巴胺和MnO_2修饰紫杉醇碳量子点协同治疗口腔鳞状细胞癌的体外研究. 兰州大学. 2023.
[5] 张明鸣, 程惊秋, 陆燕蓉, 翟宏军, 陈又南, 伍晓汀 , et al. 不同营养支持途径对外科创伤应激后相关肠黏膜形态和屏障功能影响的实验研究. 四川大学学报(医学版). 2009;40(04):615-8.
[6] 沙杰, 郭华, 毛倩倩. 医护一体化干预对口腔癌手术患者心理状态及并发症的影响. 癌症进展. 2020;18(09): 955-8.
[7] 黄春珍, 侯凌烨, 石慧娟, 符景暧, 唐盛玉. 术前营养风险评估与干预对口腔癌患者预后的效果评价. 中国实用护理杂志. 2019;35(4):292-7.
[8] 韩秋叶. 早期肠内营养支持对口腔癌术后放化疗患者的影响. 上海交通大学. 2020.
[9] Shlomo AK, David JADoR. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review. International Journal of Radiation Oncology, Biology, Physics. 2012;84(3).
[10] 马秋萍, 周淑珍. 影响颌面外科肿瘤患者留置鼻饲管相关因素分析. 中国民族民间医药. 2012;21(10):77.
[11] 王震龙, 汪志明, 王金晶, 钱小丽, 周冬梅, 李宁. 经皮内镜下胃造口空肠置管术在高龄病人营养支持中的作用. 肠外与肠内营养. 2012;19(06):371-2.
[12] Wang J, Liu M, Liu C, Ye Y, Huang G. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review. Journal of radiation research. 2014;55(3).
[13] Fonseca J, Adriana C, Fróis-Borges M, Meira T, Oliveira G, Santos JC. Ostomy metastasis after pull endoscopic gastrostomy: a unique favorable outcome. Nutricion hospitalaria. 2015;31(4).