口腔颌面部脉管畸形112例手术治疗效果评价  

Surgical management of vascular malformations in the oral and maxillofacial region:evaluation of 112 cases

作　　者：孙宁宁[1] 徐大朋[1] 薛雷[1] 孙桦梁[1] 席善龙[1] 王绪凯[1] 

机构地区：[1]中国医科大学口腔医学院口腔颌面外科,沈阳110002

出　　处：《中国实用口腔科杂志》2013年第12期723-726,共4页Chinese Journal of Practical Stomatology

摘　　要：目的：评价口腔颌面部脉管畸形的手术治疗的临床疗效。方法对2008年6月至2012年10月中国医科大学口腔医学院口腔颌面外科收治的112例口腔颌面部脉管畸形患者，均采用手术切除治疗，病变切除后直接拉拢缝合83例，邻近皮瓣转移修复19例，中厚皮片移植修复10例。随访观察术后效果。结果术后病理进一步证实，静脉畸形67例、微静脉畸形8例、淋巴管畸形4例、淋巴-静脉畸形24例、动静脉畸形9例。术后1例患者发生皮片感染，化脓部分坏死，患区给予湿敷换药后创面二期愈合。随访6个月至5年，治愈105例，其余7例于术后3～10个月复发，其中1例淋巴-静脉畸形、4例动静脉畸形、2例静脉畸形。复发的静脉畸形患者，病变内注射平阳霉素后均治愈；其他复发患者均再次手术切除后治愈。结论手术切除治疗口腔颌面部脉管畸形在外形和功能上均可获得满意疗效，而且安全。Objective To analyse the surgical management experience and clinical effects in oral and maxillofacial vas-cular malformations. Methods From June 2008 to October 2012,a total of 112 patients with vascular malformations were treated with surgical therapy. Wounds were sutured directly after lesions excision in 83 cases,repaired with local flap transferring in 19 cases,with middle-thick skin graft in 10 cases. Results The pathological results showed 67 cas-es of venous malformation,8 cases of venular malformation,4 cases of lymphatic malformation,24 cases of lymphat-ic-venous malformation,and 9 cases of arteriovenous malformation. One of 10 cases receiving free skin graft had partial skin necrosis for purulent infection and achieved healing by second intention after dressing changes. All patients were fol-lowed up for from 6 months to 5 years. Among 112 cases receiving simple surgical management,105 cases were cured. Recurence occurred in 7 cases from 3 months to 10 months after operation,including 1 case of lymphatic-venous malfor-mation,4 cases of arteriovenous malformation and 2 cases of venous malformation. Recurrent venous malformations were treated with injection of pingyangmycin and then were cured. The others were cured after second operation. Conclusion Vascular malformations in the oral and maxillofacial region can be treated safely using surgery with satisfactory results esthetically and functionally.

关 键 词：口腔颌面部 脉管畸形 手术治疗 

分 类 号：R78[医药卫生—口腔医学]