同期神经化髂骨瓣重建下颌骨对术后远期生存质量的影响

doi:10.19438/j.cjoms.2026.03.006

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (3): 241-246.doi: 10.19438/j.cjoms.2026.03.006

同期神经化髂骨瓣重建下颌骨对术后远期生存质量的影响

王婕妤¹, 张于涵¹, 史敬存¹, 张冰清¹, 古力为¹, 张忆楠¹, 王磊^1,2

1.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院, 国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011;
2.上海市奉贤区奉城医院口腔颌面-头颈肿瘤科,上海 201411

收稿日期:2025-10-09 修回日期:2026-02-07 出版日期:2026-05-20 发布日期:2026-06-04
通讯作者: 王磊,E-mail: wangleizyh@aliyun.com
作者简介:王婕妤（2000—）,女,硕士研究生,E-mail: jieyuw51700@163.com
基金资助:
国家自然科学基金（81970907）; 上海市卫生健康委员会卫生行业临床研究专项（202340135）; 上海交通大学口腔医学院国家自然科学基金提升项目（TSMS202501）; 上海第九人民医院RCT研究专项基金（2025RCTB04）

Influence of simultaneous innervated iliac bone flap on long-term quality of life after mandibular reconstruction

Wang Jieyu¹, Zhang Yuhan¹, Shi Jingcun¹, Zhang Bingqing¹, Gu Liwei¹, Zhang Yinan¹, Wang Lei^1,2

1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Oromaxillofacial Head and Neck Oncology, Fengcheng Hospital, Fengxian District. Shanghai 201411, China

Received:2025-10-09 Revised:2026-02-07 Online:2026-05-20 Published:2026-06-04

摘要/Abstract

摘要： 目的: 探讨同期神经化髂骨瓣与传统血管化髂骨瓣重建下颌骨术后患者远期生存质量的差异。方法: 选择2019年5月—2022年1月于上海交通大学医学院附属第九人民医院接受下颌骨重建的24例成年患者,根据手术方式分为神经化组与非神经化组,每组各12例。神经化组采用血管化游离髂骨瓣移植+髂腹股沟神经与下牙槽神经显微吻合,非神经化组仅行血管化游离髂骨瓣移植,未行神经吻合。术后3年通过华盛顿大学生存质量问卷（University of Washington Quality of Life Questionnaire,UW-QOL）评估患者总体生存质量,采用自制下牙槽神经（inferior alveolar nerve,IAN）相关问卷评估感觉神经恢复相关生存质量。结果: 共回收有效问卷48份。UW-QOL结果显示,神经化组咀嚼、发音等核心功能条目得分高于非神经化组,两组得分最低条目均为外貌与焦虑。自制IAN相关问卷结果显示,神经化组感觉相关条目得分均高于非神经化组,且12个问题总分更高。结论: 同期神经化髂骨瓣可有效改善下颌骨缺损患者术后远期感觉神经功能相关生存质量,其神经-骨协同重建模式为实现移植骨远期稳定与感觉功能恢复提供了可能。

关键词: 生存质量, 神经吻合, 髂骨瓣, 颌骨重建, 华盛顿大学生存质量问卷

Abstract: PURPOSE: To investigate the differences in the long-term quality of life between patients undergoing mandibular reconstruction with simultaneous innervated iliac bone flap and those with traditional vascularized iliac bone flap. METHODS: A total of 24 adult patients who received mandibular reconstruction at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from May 2019 to January 2022 were enrolled and divided into an innervated group (IN group) and a non-innervated group (CO group) with 12 cases in each according to the surgical method. The IN group underwent free vascularized iliac bone flap transplantation combined with microanastomosis of the ilioinguinal nerve and the inferior alveolar nerve, while the CO group only received free vascularized iliac bone flap transplantation without nerve anastomosis. At 3 years postoperatively, the University of Washington Quality of Life Questionnaire (UW-QOL) was used to evaluate the patients' overall QoL, and a self-designed questionnaire related to the inferior alveolar nerve (IAN) was adopted to assess the QoL associated with sensory nerve recovery. RESULTS: A total of 48 valid questionnaires were retrieved. The results of the UW-QOL showed that the IN group had higher scores than the CO group in core functional items such as chewing and pronunciation. The items with the lowest scores in both groups were appearance and anxiety. The results of the self-developed IAN-related questionnaire indicated that the IN group had higher scores in sensory-related items than the CO group, and the total score of the 12 questions was also higher. CONCLUSIONS: Simultaneous innervated iliac bone flaps can effectively improve the long-term quality of life related to sensory nerve function in patients with mandibular defects. The nerve-bone collaborative reconstruction model provides the possibility for achieving long-term stability of the transplanted bone and the recovery of sensory function.

Key words: Quality of life, Nerve anastomosis, Iliac bone flap, Mandibular reconstruction, UW-QOL

中图分类号:

R782.2

王婕妤, 张于涵, 史敬存, 张冰清, 古力为, 张忆楠, 王磊. 同期神经化髂骨瓣重建下颌骨对术后远期生存质量的影响[J]. 中国口腔颌面外科杂志, 2026, 24(3): 241-246.

Wang Jieyu, Zhang Yuhan, Shi Jingcun, Zhang Bingqing, Gu Liwei, Zhang Yinan, Wang Lei. Influence of simultaneous innervated iliac bone flap on long-term quality of life after mandibular reconstruction[J]. China J Oral Maxillofac Surg, 2026, 24(3): 241-246.

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同期神经化髂骨瓣重建下颌骨对术后远期生存质量的影响

Influence of simultaneous innervated iliac bone flap on long-term quality of life after mandibular reconstruction

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