旋股外侧血管嵌合皮瓣的解剖学基础及在口腔颌面部缺损重建中的应用  

Anatomy on chimeric flaps of lateral circumflex femoral vessel and application for the reconstruction of complex oral and maxillofacial defects

作　　者：龚朝建[1] 王铠[1] 张胜[1] 谭宏宇[1] 朱兆夫[1] 刘金兵[1] 任振虎[1] 吴汉江[1] 

机构地区：[1]中南大学湘雅二医院口腔中心颌面外科,长沙410011

出　　处：《中华显微外科杂志》2014年第5期436-439,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金（81301757）;湖南省自然科学基金（12JJ5067）

摘　　要：目的探讨旋股外侧血管嵌合皮瓣的解剖学基础及其在口腔颌面部复杂缺损重建中的应用效果。方法选取2008年10月至2009年4月行旋股外侧血管皮瓣修复口腔颌面部缺损患者66例，术中解剖观察旋股外侧血管皮穿支的分布、数量、类型及来源；回顾并分析2008年10月至2011年10月应用旋股外侧血管嵌合皮瓣修复口腔颌面部洞穿性缺损29例，其中颊部26例，口底一颏部2例，鼻底1例。结果66例患者股前区共有旋股外侧血管皮穿支333支，平均5．0（1～9）支；股前外侧区有皮穿支282支，平均4．3（1—8）支，78．7％来源于降支，19．9％来源于横支，1．4％来源于升支，85．5％的穿支血管为肌皮穿支，肌间隙穿支占14．5％；38例患者股前内侧区存在旋股外侧血管皮穿支。29例嵌合皮瓣28例成活，1例坏死，成功率96．6％；所有患者随访6～36个月，术后供、受区外形及功能恢复满意。结论旋股外侧血管嵌合皮瓣设计灵活，适合于口腔颌面部复杂缺损的修复重建。Objective To discuss the anatomic basis for design of chimeric flaps pedicled with lateral circumflex femoral vessel and to evaluate the feasibility of the chimeric flaps for the reconstruction of complex oral and maxillofacial defects. Methods Sixty-six patients who underwent oral and maxillofacial malignant tumor resection and reconstruction with the flaps pedicled with lateral circumflex femoral vessel from October, 2008 to April, 2009 in the Second Xiangya Hospital were selected as the subjects. The distribution, number, type and origin of cutaneous perforators arising from lateral circumflex femoral vessel in the anterior thigh region were explored by anatomic observation. A retrospective review was performed of 29 patients who underwent reconstruction of through-and-through oral and maxillofacial defects with chimeric flaps pedicled with lateral circumflex femoral vessel from October 2008 to October 2011. The chimeric flaps were harvested to reconstruct through-and-through cheek defects in 26 cases, through- and- through defects from floor of the mouth to mental region in 2 cases, through- and- through defects of basis nasi in 1 case. Results In the 66 cases, 333 cutaneous perforators originating from the lateral circumflex femoral vessel were present in the anterior thigh region （5. 0 perforators per case on average; range, 1 to 9 ）. And 282 cutaneous perforators were present in the anterolateral thigh region （4. 3 perforators per case on average; range, 1 to 8）. 78.7% of cutaneous perforators in the anterolateral thigh region derived from the descending branch of the lateral circumflex femoral artery （LCFA）, 19.9% derived from the transverse branch of the LCFA, 1.4% derived from the ascending branch of the LCFA. Further, most perforators （85.5%） in the anterolateral thigh region were musculocutaneous perforators; the rest （14. 5% ） were septocutaneous perforators. In addition, 38 cases of patients had cutaneous perforators deriving from the lateral circumflex femoral vessel in the

关 键 词：口腔颌面部 旋股外侧血管 嵌合皮瓣 显微外科手术 

分 类 号：R782.4[医药卫生—口腔医学]