股前外侧肌皮瓣909块在口腔颌面缺损修复中的应用  

Application of 909 anterolateral thigh myocutaneous flaps in the reconstruction of oral and maxillofacial defects

作　　者：李波[1,2] 任振虎[1] 王铠[1] 陈梅[3] 吴汉江[1] 

机构地区：[1]中南大学湘雅二医院口腔医学中心,长沙410011 [2]桂林医学院附属医院口腔科,广西541001 [3]桂林医学院附属医院口腔科

出　　处：《中华口腔医学杂志》2015年第3期169-172,共4页Chinese Journal of Stomatology

摘　　要：目的 总结股前外侧肌皮瓣在颌面部修复重建中的应用价值.方法 收集2004年1月至2012年12月中南大学湘雅二医院口腔医学中心行股前外侧肌皮瓣修复的患者889例（909块皮瓣）,年龄19～81岁,平均51.2岁;单叶瓣761块,一蒂多岛瓣148块,单皮瓣最大面积28 cm×12 cm,最小4 cm×2 cm.结果 909块皮瓣成活882块,坏死27块,成活率97.0％.皮瓣供区主要并发症：伤口愈合不佳9.6％（87/909）、供区皮肤感觉异常61.0％ （500/820）、股四头肌肌力减弱15.0％（123/820）,局部无严重并发症出现.股前外侧肌皮瓣重建口腔颌面部各部位的缺损后,90％以上的患者得到了良好的功能恢复及美观效果.结论 股前外侧肌皮瓣可作为口腔颌面部缺损修复的首选皮瓣.Objective To summarize the application of 909 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects and to examine their benefits in maxillofacial reconstruction of these defects.Methods Patients were recruited from January 2004 to December 2012 in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital of Central South University.All patients underwent reconstructive surgery with anterolateral thigh myocutaneous flaps,and patient age ranged from 19 to 81 years with a mean of 51.2 years.There were 761 flaps showing single lobe and 148 flaps showing a multi-island pedicle.The largest area among the single flaps was 28 cm× 12 cm,and the smallest was 4 cm× 2 cm.Results Among the 909 transferred flaps,882 survived and 27 showed necrosis,with a survival rate of about 97.0%.The common complications at flap donor site were poor wound healing 9.6%（87/909）,localized paresthesia 61.0%（500/820）,and altered quadriceps force 15.0%（123/820）.No case was presented with local serious complications,and 90% of the patients achieved good functional recovery and aesthetically acceptable results after the reconstruction by anterolateral thigh myocutaneous flaps.Conclusions The anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps and should be preferred.

关 键 词：外科皮瓣 口腔肿瘤 颌面部缺损 

分 类 号：R739.8[医药卫生—肿瘤]