口腔颌面部肿瘤术后组织缺损修复的临床研究  

Clinical research of reconstruction for oral and maxillofacial tumorectomy postoperative complex tissue defect

作　　者：万冠群 巫国辉[1] 李小林[1] 

机构地区：[1]江西省人民医院整形颌面外科江西省颌面整形与再造重点实验室,江西南昌330006

出　　处：《中国美容医学》2015年第6期24-27,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨口腔颌面部肿瘤术后复合组织缺损修复的方法。方法:应用回顾性研究的方法,对我科近年收治的29例因"口腔癌联合根治"导致术后口腔颌面部复合组织缺损、并行即刻修复和功能重建的患者进行分析总结。结果:本组29病例中,23例术后修复皮瓣完全成活,创口一期愈合;1例胸大肌皮瓣远端部分缺血坏死,皮瓣部分成活(约80%),创口二期愈合;1例胸大肌皮瓣和移植髂骨部分坏死、感染而清除坏死皮瓣和髂骨;4例口腔膜修复病例二期愈合,无感染坏死。前臂皮瓣再造舌形态较好,胸大肌皮瓣再造舌形态臃肿,两者再造舌的感觉和活动度较差,但随着时间的延长而逐渐改善。结论:胸大肌肌皮瓣、前臂皮瓣和髂骨等是口腔颌面部复合组织缺损修复再造的理想选择。Absatract：Objective To explore the methods of reconstruction for oral and maxillofacial tumorectomy postoperative complex tissue defect. Methods Based on a retrospective study, the records of 29 patients admitted to our department with parallel immediate repair and functional reconstruction for oral and maxillofacial complex tissue defect resulting from oral cancer tumorectomy were analyzed. Results Among the 29 patients,primary healing were showed in 23 patients with the flap survived. Partial avascular necrosis in the distal end and secondary healing of the incision were observed in a pectoralis major myocutaneous flap（PMMF）,about 80% of which survived.In addition,one PMMF combined with flank bone transplant was removed because of Subtotal necrosis and infection. Secondary healing was found in 4 patients repaired with oral membrane,but no infection or necrosis. Satisfied appearance of tongue can be reconstructed by antebrachial flap,while swollen appearance by PMMF.Furthermore,fairly poor movement and sensation of tongue were got by both antebrachial flap and PMMF,which could gradually be improved with time- variation. Conclusion PMMF, antebrachial flap,flank bone and buccal pad are ideal choices for reconstruction of oral and maxillofacial complex tissue defect.

关 键 词：口腔癌 组织缺损 胸大肌皮瓣 前臂皮瓣 修复重建 

分 类 号：R782[医药卫生—口腔医学]