改良数字化导板技术在腓骨瓣重建下颌骨缺损中的应用  

The application of modified surgical guide system in mandibular reconstruction with a fibula flap

作　　者：刘杭飞 包霆威[1] 赵文权[1] 余丹[1] 朱慧勇[1] LIU Hangfei;BAO Tingwei;ZHAO Wenquan(First Affiliated Hospital,College of Medicine,Zhejimg University,Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属第一医院,杭州310003

出　　处：《浙江创伤外科》2019年第2期220-223,共4页Zhejiang Journal of Traumatic Surgery

基　　金：国家自然科学基金资助(编号:31570989)

摘　　要：目的评估三维虚拟计划的效果及改良数字化导板技术在辅助游离腓骨瓣精确重建下颌骨缺损中的应用。方法本文回顾分析了35例接受了游离腓骨瓣修复重建下颌骨缺损的患者。根据手术类型分为三组。A组12名患者使用改良数字化导板技术进行重建。B组14名患者使用常规导板技术进行下颌骨重建。C组9名患者根据医生的临床经验进行重建。所有病例均评估总手术时间,皮瓣缺血时间,手术精确性和术后并发症等。结果所有腓骨瓣均存活。A组缺血时间短于B组和C组(P<0.05)。A组平均下颌角点和髁状突移位低于B组和C组(P<0.01)。结论改良数字化导板技术的应用可减少腓骨瓣重建下颌骨缺损的总手术时间和皮瓣缺血时间,提高重建精确度,是一种精确且可靠的技术。Objective To evaluate the effects of the three-dimensional virtual planning and the application of modified digital guide technology in precise mandibular reconstruction with a fibula flap. Methods This article Retrospectively reviewed 35 patients who underwent mandibular construction with a free fibula flap.They were divided into three groups according tothe surgical methods.12 patients in Group A underwent reconstruction by using modified digital guide technology.14 patients in Group B underwent reconstruction by using conventional guide technology.9 patients in Group C underwent surgery on the basis of surgeon’s experience.The operation time,ischemia time of the fibula flaps,accuracy of surgery and postoperative complications were recorded and analyzed. Results All fibulaflaps were survived.The ischemia time of Group A was shorter than that of group B and C (P<0.05). The average gonion and condyle shift of Group A was smaller than those of group B and C (P<0.01). Conclusion The application of modified digital guide technology in mandibular reconstruction with a fibula flap could shorten the total operation time and ischemia time of flaps,improved the accuracy of reconstruction,which was a precise and reliable technique.

关 键 词：游离腓骨瓣 三维虚拟计划 改良数字化导板技术 精确 

分 类 号：R687.3[医药卫生—骨科学]