吻合血管的髂骨复合瓣重建下颌骨缺损的临床评价  

Mandibular reconstruction with vascularized iliac composite flaps

作　　者：南欣荣[1] 令狐清溪[1] 唐友盛[2] 沈国芳[2] 

机构地区：[1]山西医科大学第一临床医学院口腔颌面外科,太原030001 [2]上海第二医科大学第九人民医院口腔颌面外科

出　　处：《山西医科大学学报》2002年第5期451-453,共3页Journal of Shanxi Medical University

摘　　要：目的　报告吻合旋髂深血管髂骨复合瓣移植重建下颌骨缺损的前瞻性临床研究结果。方法　对 63例下颌骨缺损患者采用髂骨复合瓣进行重建 ,并进行连续随访观察 ,对面形与口颌功能进行临床评价 ,其中张口度与口腔容量进行量化。结果　游离组织瓣移植总成功率为 97.1 % ,髂骨复合瓣为 96 .9% ,皮岛坏死率为 2 7.3 %。供区切口疝与股神经麻痹各发生 1例。多数患者术后面部外形及语言、吞咽、张口度和含水试验等口颌功能恢复正常或接近正常。结论　髂骨复合瓣修复单纯下颌骨缺损 ,面部外形与口颌功能的恢复均较为理想 ;因其携带皮岛过于臃肿 ,影响面部外形与口颌功能 ,与前臂皮瓣串联可弥补其不足 ;Objective To explore the prospective clinical effects of mandibular reconstruction with vascularized iliac composite flaps. Methods A total of 63 patients underwent the mandibular reconstruction with vascularized iliac composite flaps and were succesively followed up. For each patient, the facial contour and oral maxillary function were evaluated, including measuring the opening mouth height and volume of oral cavity. Results The success rate of free flaps was 97.1% and that of iliac composite flaps was 96 9%. The necrosis rate of skin island was 27.3%. The complications of abdominal hernia happened in one patient, and palsy of femoral nerve in another. Most postoperative patients recovered. The facial contour and functions of language, swallowing,opening mouth extent and containing water test were normal or almost normal after operation. Conclusion The contour of face and oral maxillary functions are regained with iliac flaps repairing simple mandibular defects. For the patients with occurrence of massive skin island and imperfect recovery of facial contour and oral maxillary function in iliac composite flaps, they should be combined with forearm flaps for the massive soft and skeletal defects in mandible. The complications of donor area are acceptable.

关 键 词：吻合血管 临床评价 整形外科 下颌修复术 下颌缺损 

分 类 号：R782.23[医药卫生—口腔医学]