旋髂浅动脉穿支皮瓣在口腔癌术后修复中的应用研究  

Application of superficial circumflex iliac artery perforator flap in reconstruction after radical surgery of oral cancer

作　　者：何悦[1] 金淑芳[1] 方早[1] 田卓炜 邱蔚六[1] 章一新[2] 冯少清[2] 陶晓峰[3] 周辉红[4] 张志愿[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院整复外科,上海200011 [3]上海交通大学医学院附属第九人民医院放射科,上海200011 [4]上海交通大学医学院附属第九人民医院超声诊断科,上海200011

出　　处：《上海交通大学学报（医学版）》2016年第8期1175-1180,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金面上项目(81570949,81271112);上海市教育委员会高原高峰学科建设计划(20152222)~~

摘　　要：目的·探讨旋髂浅动脉穿支(SCIP)皮瓣的影像学、解剖学及其在口腔癌术后修复中的临床应用。方法·采用SCIP皮瓣修复15例口腔癌根治术后缺损。所有患者术前均进行CT血管造影、彩色多普勒超声和/或磁共振血管造影检査。术中进行穿支皮瓣的血管解剖,受区缺损重建,对术后受、供区功能恢复进行评价。术后随访2~10个月。结果·切取的SCIP皮瓣平均面积为(46±22)cm^2,平均厚度为(1.2±0.3)cm;旋髂浅动脉与旋髂深动脉和腹壁浅动脉的关系可以分为5型:Ⅰ型(8/15),Ⅱ型(2/15),Ⅲ型(2/15),Ⅳ型(2/15),Ⅴ型(1/15)。患者术后受区外形丰满,张口度、语音和咀嚼功能恢复良好。结论·SCIP皮瓣质地柔软,穿支血管蒂较长,供区瘢痕隐蔽,是修复口腔癌缺损的良好选择。Objective · To investigate the anatomic and imaging characteristics of superficial circumflex iliac artery perforator （SCIP） flap and its clinical application in reconstruction after radical surgery of oral cancer. Methods · Fifteen patients underwent the SCIP flap reconstruction after radical surgery of oral cancer. All patients received preoperative examinations with CT angiography, color Doppler ultrasonography and/or MR angiography. The vascular dissection for superficial circumflex iliac artery （SCIA） and defect reconstruction were performed intra-operatively. The function recovery in recipient and donor sites was evaluated postoperatively. Patients were followed up for 2-10 months. Results · The average area and thickness of dissected flaps were （46 ± 22） cm^2 and （1.2 ± 0.3） cm, respectively. The relationship between SCIA, deep circumflex iliac artery （DCIA）, and superficial inferior epigastric artery （SIEA） could be classified into type 1 （8/15）, type 2 （2/15）, type 3 （2/15）, type 4 （2/15）, and type 5 （1/15）. Good aesthetic outcome was obtained after surgery in the recipient sites and mouth-open width, speech, and mastication function recovered well. Conclusion · The SCIP flap is a pliable flap with long vascular pedicles and hidden donor site morbidity and an ideal option for oral maxillofacial defect reconstruction.

关 键 词：穿支皮瓣 旋髂浅动脉 颌面部 癌 缺损重建 

分 类 号：R739.85[医药卫生—肿瘤]