46例口腔颌面部游离腓骨瓣移植的临床分析  

A review of 46 consecutive free fibula flap transfers for head and neck reconstruction

作　　者：毛驰[1] 俞光岩[1] 彭歆[1] 郭传瑸[1] 黄敏娴[1] 张益[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,100081

出　　处：《现代口腔医学杂志》2002年第1期51-53,共3页Journal of Modern Stomatology

摘　　要：目的　对 46例口腔颌面部游离腓骨瓣移植作回顾性分析。方法　分析所采用腓骨瓣的设计、受区血管、血管吻合方式和技术、组织瓣成活情况及术后并发症的发生情况 ,并分析有可能影响皮瓣成活的各种因素。结果　 46例腓骨瓣中 41例用于下颌骨重建 ,5例用于上颌骨重建 ,其中 44例获得成活 ,成功率为 95 .7%。 1例腓骨瓣因术中损伤血管而改用游离腓骨移植 ,另 1例因静脉血栓而失败。组织瓣移植术后血栓的发生率为 8.7%,抢救成功率为 5 0 %;受区和供区总的并发症发生率为 2 1.7%,除了 4例供区并发症外 ,其余的并发症均不严重 ,没有造成明显的后果 ;吸烟、饮酒、放疗和年龄 (高龄和儿童 )等均非影响游离组织移植成功的重要因素。结论　游离腓骨瓣在颌骨缺损的修复中具有很大的灵活性 ,安全可靠 ,制备简便 ,供区并发症少 ,值得进一步推广和应用。Objective To review 46 consecutive free fibula flap transfers for head and neck reconstruction in a new microsurgery unit.Methods Forty-six consecutive free fibula flap transfers performed from Jume 21 1999 to August 4 2000 were reviewed.Data concerning the operation included date of surgery,defect description and site,stage and histology of tumor,design of free fibula flap,recipient vessel and type of anastomosis used and complications.Results Among the 46 free fibula flaps,41 were used for mandibular reconstruction,5 were used for maxillary reconstruction.Forty-four of the 46 flaps survived completely,with the overall success rate of 95.7 %.One flap was changed into free fibula graft because of injury of the vessels,and another one flap was lost because of venous thrombosis.The overall complication rate was 21.7% .The vessel thrombosis rate was 8.7% and the flap salvage rate was 50%.Conclusion Free fibula flap is versatile and reliable for reconstruction of head and neck defects.It can be used for both mandibular and maxillary reconstruction.

关 键 词：游离腓骨瓣 显微外科 重建 口腔颌面部 

分 类 号：R782.2[医药卫生—口腔医学]