Tarle Marko, Čvrljević Igor, Raguž Marina, Lukšić Ivica
Department of Maxillofacial Surgery, Dubrava University Hospital, 10000 Zagreb, Croatia.
School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
J Clin Med. 2023 Aug 15;12(16):5314. doi: 10.3390/jcm12165314.
Significant advances in reconstructive head and neck surgery with free microvascular flaps have had a positive impact on esthetic outcomes and quality of life. However, complications still occur in some patients. This study investigated the influence of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score (HALP score), an immunonutritive marker, on complications and flap success. The retrospective analysis included 194 patients who underwent reconstruction of head and neck defects with free microvascular flaps. The HALP score correlated strongly with overall complications, including flap necrosis, infection, fistula, and hematoma. Hemoglobin, albumin, lymphocytes, and platelets individually showed associations with specific complications. HALP score was an extremely strong predictor of complications (AUC = 0.85). HALP score may be valuable for assessing patient status and predicting complications in microvascular free-flap reconstruction to allow timely interventions and improve outcomes. Further research is needed to investigate additional predictors and improve postoperative care.
使用游离微血管皮瓣进行的头颈部重建手术取得了重大进展，对美学效果和生活质量产生了积极影响。然而，仍有一些患者会出现并发症。本研究调查了免疫营养标志物血红蛋白、白蛋白、淋巴细胞和血小板评分（HALP评分）对并发症和皮瓣成功率的影响。回顾性分析纳入了194例行游离微血管皮瓣修复头颈部缺损的患者。HALP评分与包括皮瓣坏死、感染、瘘管和血肿在内的总体并发症密切相关。血红蛋白、白蛋白、淋巴细胞和血小板分别与特定并发症相关。HALP评分是并发症的极强预测指标（AUC = 0.85）。HALP评分对于评估微血管游离皮瓣重建患者的状况和预测并发症可能具有重要价值，以便及时进行干预并改善治疗效果。需要进一步研究以调查其他预测指标并改善术后护理。
