游离股前外侧皮瓣在颊癌根治术后缺损修复中的应用  

Reconstruction of buccal defect using free anterolateral thigh flaps after radical resection of buccal cancer

作　　者：周婷[1] 孙国文[1] 卢明星[1] 文健民 陈欣[1] 曹俊[1] Zhou Ting Sun Gouwen Lu Mingxing Wen Jianmin Chen Xin Cao Jun.(Oral and Maxillofacial Surgery Department, Nanjing Stomatologieal Hospital, Medical School of Nanjing University, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,210008

出　　处：《中华整形外科杂志》2017年第1期30-33,共4页Chinese Journal of Plastic Surgery

基　　金：江苏省临床医学科技专项项目（BL2013005）;江苏省卫生厅课题项目（H201441）;南京市科技发展计划项目（201503038）;南京市医学科技发展资金（ykk13150）

摘　　要：目的探讨不同类型游离股前外侧皮瓣修复颊癌根治术后缺损的效果。方法2009年3月至2016年5月收治142例颊癌患者，行肿瘤根治术后应用不同类型的股前外侧组织瓣同期修复，对其临床资料进行回顾性分析。结果142例中以股前外侧肌皮瓣修复60例，股前外侧脂肪筋膜皮瓣60例，薄型股前外侧皮瓣22例，皮瓣大小为4cm×5em～14emx10cm，其中成活140例，术后发生血管危象4例，经探查及相应处理后2例完全成活，2例坏死，改以前臂皮瓣修复。术后随访3～85个月，平均37个月，颊部受区皮瓣成活良好，术后6个月患者张口度、咀嚼、吞咽、语音功能得到良好恢复，大腿供区运动功能良好，无麻木、疼痛不适。结论颊癌根治术后遗留的缺损，以不同类型的游离股前外侧皮瓣进行修复重建，颊部功能及外形恢复较为理想。Objective To explore the value of different designed anterolateral thigh flaps（ALT） in the reconstruction of buccal defect after radical resection of buccal cancer. Methods From March 2009 to May 2016, 142 cases were diagnosed as buccal cancer in the Department of Oral and Maxillofaeial Surgery of Nanjing University. All patient underwent radical resection, followed by reconstruction with different anterolateral thigh flaps. The clinical date were retrospectively analyzed. Results Among 142 cases,the muscuiocutaneous ALT flaps were used in 60 cases, the fasciocutaneous ALT flaps in 60, and the thin ALT flaps in 22. The size of the flaps ranged from 4 cm x 5 mn to 14 cm x 10 cm. Operative exploration during the perioperative period were performed in 4 patients, including 2 flaps with thrombotic events and 2 flaps with venous thrombosis. Among them, 2 flaps survived completely and 2 flaps were failure. The mean follow-up period was 37 months （range： 3 to 85 months ）. Conclusions The different designed anterolateral thigh flap for the buccal defects resulting from tumour excision is an ideal choice for reconstruction of buccal defects.

关 键 词：游离皮瓣 股前外侧皮瓣 颊部 癌 鳞状细胞 

分 类 号：R739.8[医药卫生—肿瘤]