面静脉分布走行对颏下岛状皮瓣修复疗效观察  

Clinical observation of island flap in facial vein distribution walking submental

作　　者：王文茉 张力平[1] 

机构地区：[1]中国医科大学附属盛京医院口腔颌面外科,辽宁沈阳110004

出　　处：《创伤与急危重病医学》2016年第3期148-151,共4页Trauma and Critical Care Medicine

基　　金：辽宁省科技攻关课题(2011225020)

摘　　要：目的探讨面静脉及其分支走行对颏下岛状皮瓣修复的临床效果,为临床应用充实解剖学数据。方法选取2011年1月至2015年12月我科收治的32例口腔颌面部恶性肿瘤患者,应用颏下岛状皮瓣治疗颌面部缺损,术中记录并分析观察面静脉及其分支回流方式变异情况。结果 32例患者中,除2例面静脉走行于二腹肌前腹,术中皮瓣制取失败,其余均为Ⅰ期愈合。术后半年随访,除1例皮瓣坏死,其余皮瓣颜色红润,血运良好,均未发生严重并发症。术中发现12例患者的6种面静脉变异解剖结构,变异比例约为37.49%。面静脉与颈前静脉相通4例,占12.50%;面静脉于颌下腺内走行而后注入面总静脉1例,占3.12%;面静脉于颌下腺被膜内走行,汇入面总静脉2例,占6.25%;面静脉直接汇入颈外静脉2例,占6.25%;面静脉直接汇入颈内静脉1例,占3.12%;面静脉的颏下静脉分支走行于二腹肌前腹2例,占6.25%。结论应用颏下岛状皮瓣治疗口腔颌面部缺损时,熟练掌握面静脉变异走行有助于选择正确合适的手术方法,以提高皮瓣成活率。Objective To explore the walking across the vein and its branches to do clinical observation,and to investigate the clinical application of full anatomical data. Methods A retrospective study was performed on 32 cases of patients with oral and maxillofacial malignant tumor received in Shengjing Hospital Affiliated to Chinese Medical University from January2011 to December 2015. Application of chin island flap to treat maxillofacial defects,intraoperative observation of the surface vein and its branches reflux mode changes were recorded and analyzed. Results Among 32 cases of patients,except2 cases of facial vein left abdomen before the two abs,intraoperative flap failure,the rest ones were primary healing. Postoperative follow-up of six months,except 1 case of skin flap necrosis,the rest of the skin flap,ruddy color,good blood supply were not serious complications occurred. Walking reflux study found that a total of six kinds of variation,four cases of facial vein and carotid veins interlinked,accounting for 12. 5%; 1 case of facial vein in the submandibular gland in lines and then injected into the facial vein,which accounted for 3. 12%; 2 cases of facial vein in the submandibular gland capsule walking,import facial vein,6. 25%; 2 cases of facial vein directly drained into the external jugular vein,6. 25%; 1 case of facial vein directly into the internal jugular vein,accounting for 3. 12%; 2 cases of facial vein submental vein branch line in the digastrics anterior abdominal,6. 25%. The rest are normal walking. Conclusion Application of chin island flap for oral and maxillofacial defects,mastering facial vein variation course help choosing the correct surgical method,in order to improve the survival rate of flap.

关 键 词：颏下岛状皮瓣 面静脉 口腔颌面部缺损 解剖 

分 类 号：R782.2[医药卫生—口腔医学]