血管化游离组织瓣移植在口腔颌面部缺损修复中的应用  

Application of 119 vascularized free flaps transplantation in the reparation of maxillofacial region defect

作　　者：刘曙光[1] 艾伟健[1] 栾修文[1] 周会喜[1] 王治平[1] 李志强[1] 盘杰[1] 黄元瑾[2] 

机构地区：[1]广东省口腔医院.南方医科大学附属口腔医院口腔颌面外科,广州市510280 [2]广东省口腔医院.南方医科大学附属口腔医院口腔修复科,广州市510280

出　　处：《实用医学杂志》2011年第15期2742-2744,共3页The Journal of Practical Medicine

摘　　要：目的:探讨血管化游离组织瓣移植在口腔颌面部缺损修复中的应用价值。方法:自2005年10月至2011年3月,应用119块血管化游离组织瓣修复118例口腔颌面部缺损患者,分析选择游离组织瓣的类型、受区血管和组织瓣成活情况,并探讨影响血管化游离组织瓣成功率的相关因素。结果:119块血管化游离组织瓣为游离前臂皮瓣58块,游离腓骨肌皮瓣50块,游离股前外侧皮瓣10块,游离背阔肌皮瓣1块;口腔颌面部缺损部位为舌缺损49例,颊及口咽缺损10例,口底缺损7例,下颌骨缺损38例,上颌骨缺损12例,下颌骨和口咽复合型缺损1例,偏侧颜面萎缩1例。117块游离组织瓣成活,1块游离腓骨肌皮瓣和1块游离股前外侧皮瓣坏死,游离组织瓣临床成功率为98.3%;术后血管危象发生率为4.2%(5/118),抢救成功率60%。结论:合理地应用血管化游离组织瓣移植修复口腔颌面部缺损,能较好地恢复患者的面部外形和口腔功能,且较为安全可靠,值得临床推广应用。Objective To investigate the application value of vascularized free flap transplantation in the reparation of maxillofacial region defect. Method One hundred and nineteen vascularized free flaps were used to repair 118 patients with maxillofacial region defect from October 2005 to March 2011. The flap type, and status of recipient vessel and flap were analyzed, and factors concerning the survive of transplanted vaseularized free flap were investigated. Results There were 58 free radial arm flaps, 50 free fibular flaps, 10 anterolateral thigh flaps, and 1 free latissimus dorsi flap in the 119 free flaps. The maxillofacial defect contained 49 tongue defect, 10 cheek and mesopharynx defect, 7 mouth floor defect, 38 inferior maxilla defect, 12 maxilla defect, 1 inferior combined mesopharynx defect, and 1 lateral facial atrophy. The overall success rate of free flap was 98.3%. The vessel thrombosis rate was 4.2%, and the salvage rate was 60%. Conclusion Vascularized free flap transplantation for the reparation of maxillofacial defect is safe and reliable.

关 键 词：血管化游离瓣 显微外科 重建 

分 类 号：R782[医药卫生—口腔医学]