游离上臂外侧皮瓣修复舌癌患者术后软组织缺损的临床应用  

Clinical application of lateral upper arm flap in repairing postoperative soft tissue defects of tongue cancer patients

作　　者：孙宾[1] 王越[1] 尹国相 杜宝霞[1] 于子莹[1] 张伟[1] SUN Bin WANG Yue YIN Guoxiang DU Baoxia YU Ziying ZHANG Wei(Department of Oral and Maxxillofacial Surgery, Stomatology Hospital, Jilin University, Changchun 130021, China)

机构地区：[1]吉林大学口腔医院口腔颌面外科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2017年第2期408-411,I0004,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省财政厅直厅局项目资助课题(5139073431)

摘　　要：目的:探讨游离上臂外侧皮瓣修复舌癌患者术后软组织缺损的方法,评价其成活率和修复效果。方法:选择舌癌术后软组织缺损应用游离上臂外侧皮瓣修复患者10例,其中男性7例,女性3例,年龄45~67岁,平均年龄52.1岁。患者选择条件为舌癌术后单纯软组织缺损,接受修复重建术且全身情况耐受长时间手术者。患者先进行颈部淋巴结清扫和舌癌根治性切除,再根据缺损部位及缺损大小,设计切取皮瓣,修复重建舌缺损部位。术后观察皮瓣的成活情况,并根据患者修复术后舌的形态、大小、体积和舌的运动情况等评价修复效果。结果:上臂外侧皮瓣解剖稳定,制备简单,供区瘢痕隐蔽,上肢活动及感觉无异常;10例患者皮瓣全部成活,创口一期愈合,舌体形态、大小和质地达到满意,舌体运动无明显受限制,修复后患者语音和咀嚼肌吞咽功能良好,未受明显影响。结论:上臂外侧皮瓣成活率高,修复舌缺损后舌体外形功能良好,是理想的修复舌癌术后软组织缺损的游离皮瓣。Objective：To investigate the application of lateral upper arm free flap in the repair of postoperative soft tissue defects after operation in the patients with tongue cancer,and to evaluate its survival rate and repair effect.Methods：Ten patients with tongue cancer,having a desire to repair soft tissue defect after tongue cancer operation,and their systemic state could tolerate the long time operation,were selected to repair tongue cancer postoperative defects with lateral upper arm flaps.Among them,7cases were male,3cases were female;aged 45-67 years old,average 52.1years old.Radical resection of tongue cancer was primarily finished,then the flaps were designed and prepared to repair the defects of tongue according to the location and size of defects.After the operation,the survival rate of the flap was observed,and the effect of repair was evaluated according to the shape,size,volume and movement of the tongue.Results：The lateral upper arm flaps were stable and simple to prepare,the donor sites were concealed,and the upper limbs were not abnormal.All of flaps survived,and all of wounds healed primarily.The shape,size,and texture of tongues were satisfied,and the movements of tongue were not significantly restricted.After repair,the voice,mastication and swallowing function of the patients were good without obvious influence.Conclusion：The survival rate of lateral flap of upper arm is high,and the tongue shape and function were good after tongue defect repair.It is an ideal free flap for repairing the tongue tissue defect of tongue cancer after operation.

关 键 词：舌肿瘤 软组织软损 缺损修复 上臂外侧皮瓣 

分 类 号：R739.86[医药卫生—肿瘤]