游离胸肩峰动脉穿支皮瓣在口腔肿瘤术后缺损修复的临床效果  

Outcome of thoracoacromial artery perforator （TAAP） flap for reconstruction of defect after oral tumor rad- ical resection

作　　者：宋达疆[1] 李赞[1] 周晓[1] 章一新[2] 彭小伟[1] 周波[1] 吕春柳[1] 彭文[1] 欧延[1] 

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,长沙410008 [2]上海交通大学医学院附属第九人民医院整形外科

出　　处：《中华显微外科杂志》2017年第3期222-224,共3页Chinese Journal of Microsurgery

基　　金：湖南省自然科学基金面上项目（13JJ5012）;湖南省科技计划项目（2014SK3002）;湖南省卫计委课题项目（B2014-111）

摘　　要：目的观察应用游离胸肩峰动脉穿支皮瓣修复口腔肿瘤术后缺损的临床效果。方法从2010年6月至2015年4月．共收治口腔肿瘤12例，其中牙龈癌4例，舌癌3例、口颊癌5例，病程2～12个月。行肿瘤根治术后遗留4．5cm×3．5cm～6．0cm×4．5cm大小的继发软组织缺损。应用游离胸肩峰动脉穿支皮瓣修复．皮瓣长（6．5±0．6）cm、宽（4．3±0．5）cm、厚（1．1±0．3）cm，血管蒂长（8．4±0．2）cm。穿支血管蒂动脉与甲状腺上动脉吻合．伴行静脉与甲状腺上静脉或颈内静脉吻合。定期进行随访。结果所有病例胸肩峰动脉穿支恒定存在，12例皮瓣全部成活．供区创面均直接闭合。随访14～38个月，皮瓣外观满意．肿瘤局部无复发。供区仅遗留线性瘢痕．肩关节功能未见明显影响。结论胸肩峰动脉穿支皮瓣血管解剖恒定，皮瓣质地色泽好，供区损伤小，是口腔肿瘤术后缺损修复的理想选择。Objective To observe the outcome of free TAAP flap in the reconstruction of defect after oral tu- mor radical resection. Methods From June, 2010 to April, 2015, 12 patients with oral tumor underwent radical resection, including 4 cases of gingival carcinoma, 3 cases of tongue carcinoma and 5 case of buccal cancer. The cause ranged from 2 to 12 months. The radical resection left defects with size ranged from 4.5 cm×3.5 cm to 6.0 cm× 4.5 cm which were reconstructed by free TAAP flaps with size ranged from 7.0 cm×4.0 cm to 12.0 cm×8.0 cm. The length of TAAP flap was （6.5±0.6） cm. The width of flap was （4.3±0.5） cm. And the thickness of flap was （1.1±0.3） cm. The length of pedicle was（8.4±0.2） cm. All the arteries of TAAP were anastomosed with superior thyroid arteries, while the venae comitans were anastomosed with superior thyroid venae or internal jugular venae. Results The perforators existed consistently. All 12 flaps survived uneventfully. The donor sites were closed directly in all cases. All patients were followed up for 14-38 months with satisfied esthetic and functional results in reconstructed tongue. No local recurrence happened. The shoulder function was not affected. Conclusion The TAAP flap has consistent blood supply, good color match and texture, while leaving minimal morbidity at donor site, is an ideal choice for buccal tu- mor reconstruction.

关 键 词：胸肩峰动脉 穿支皮瓣 口腔肿瘤 皮瓣移植 显微外科技术 

分 类 号：R739.8[医药卫生—肿瘤] R782.2[医药卫生—临床医学]