游离组织瓣修复口腔颌面-头颈部缺损244例  

Clinical application of free flap for head and neck reconstruction in 244 patients

作　　者：段维轶[1] 徐中飞[1] 刘法昱[1] 张恩礁[1] 代炜[1] 戚忠政[1] 谭学新[1] 黄绍辉[1] 孙长伏[1] 

机构地区：[1]中国医科大学附属口腔医院口腔颌面外科口腔颌面-头颈肿瘤外科,沈阳110001

出　　处：《中华显微外科杂志》2014年第5期444-448,共5页Chinese Journal of Microsurgery

摘　　要：目的探讨各种游离组织瓣在口腔颌面-头颈部组织缺损修复中的应用。方法2010年1月至2013年12月，用游离皮瓣修复口腔颌面-头颈部缺损患者共244例，统计游离组织瓣的应用类型、成活率、血管危象发生率、并发症等，并对可能影响皮瓣成活的因素进行分析。结果249块游离组织瓣中，243块组织瓣成活，6块失败，成功率为97．6％。共有13例出现术后血管危象，血管危象发生率为5．2％；其中动脉危象2例，静脉危象11例，经探查抢救成功挽救7例，挽救成功率为54％。共有73例术后出现局部或全身并发症，发生率为29．9％。股前外侧皮瓣为最为常用的组织瓣，其次为腓骨肌皮瓣和前臂桡侧皮瓣。结论游离组织瓣对于口腔颌面-头颈部缺损是十分可靠的修复重建方法。Objective To analysis the results of different free flaps for reconstruction of head and neck defects. Methods From January, 2010 to December, 2013, 243 free flaps were performed in 244 patients in this retrospective study. Evaluated parameters were defect localization, histology of tumor, free flap type, recipient vessels and complications. Results Total 243 free flaps were transplanted successfully except 6 flaps failured. The overall flap survival rate was approximately 97.6%. Thirty-three cases were encountered vascular complication, which rate was 5.2%. There were arterial crisis in 2 cases and venous crisis in 11 cases. Seven cases survived by explorative operation. The flap salvage rate was 54%. Seventy-three cases suffered local or systemic complications, and overall complication rate was 29.9%. The anterolateral thigh flap was most commonly used, followed by free fibula flap and free radial forearm flap. Conclusion Free flap is a reliable method for reconstruction of head and neck defect.

关 键 词：头颈部缺损 游离皮瓣 重建 显微外科手术 

分 类 号：R782.4[医药卫生—口腔医学]