股前外侧皮瓣在口腔颌面部修复重建中的临床应用  

Anterolateral Thigh Flap in Oral and Maxillofacial Reconstruction

作　　者：向旭[1] 史平[1] 杨立[1] 许振起[1] 龙丽[1] 穆洁[1] 张萍[1] 张建成[1] 沈军[1] Xiang Xu;Shi Ping;Yang Li;Xu Zhenqi;Long Li;Mu Jie;Zhang Ping;Zhang Jiancheng;Shen Jun(Department of Maxillofacial Surgery, Tianjin Stomatological Hospital & Stomatological Hospital Affiliated to Nankai University, Tiarijin 300041 , China)

机构地区：[1]天津市口腔医院.南开大学口腔医院颌面外科

出　　处：《肿瘤预防与治疗》2019年第7期588-593,共6页Journal of Cancer Control And Treatment

基　　金：天津市卫生健康委员会攻关项目(编号:06KG04)~~

摘　　要：目的:探讨修复各类口腔颌面部缺损时应用游离股前外侧皮瓣的可能性和实用性。方法:2011年3月至2018年12月共开展股前外侧皮瓣移植术63例,皮瓣最小面积4cm×6cm,最大面积7cm×22cm;修复缺损部位有舌部26例,颊部15例,口底区8例,下颌6例,口咽部3例,上颌2例,软腭2例,面部大面积缺损1例。其中,肌皮瓣55例,分叶皮瓣8例。术中一期削薄48例,其中粗修46例,精修2例。结果:游离股前外侧皮瓣的临床成活率为98. 4%(62/63)。术后血管危象2例,其中1例抢救成功,失败1例(组织瓣坏死)。削薄皮瓣均无坏死,无大腿皮瓣供区感染。术后患者的面部外形以及咀嚼、吞咽和语言功能均可接受。结论:游离股前外侧皮瓣可以很好地修复口腔颌面部各种复杂的缺损。Objective: To discuss the possibility and practicability of free anterolateral thigh flaps in repairing various oral and maxillofacial defects. Methods: From March 2011 to December 2018 , 63 cases of anterolateral femoral flaps were transplanted. The minimum area of the flaps was 4 cm × 6 cm and the maximum area was 7cm × 22 cm. The defects were repaired in 26 cases of tongue, 15 cases of cheek, 8 cases of floor of mouth, 6 cases of mandible, 3 cases of oropharynx, 2 cases of maxilla, 2 cases of soft palate and 1 case of large facial defect. Among them, 55 cases were myocutaneous flaps and 8 cases were lobulated skin flap. There were 48 cases of primary thinning during operation, including 46 cases of rough repair and 2 cases of fine repair. Results: The clinical survival rate of free anterolateral thigh flaps was 98.4%(62/63). Postoperative vascular crisis occurred in 2 cases, including 1 successful rescue, 1 failure and necrosis of tissue flaps. No necrosis and infection of donor site were found in the thin skin flaps. All patients achieved acceptable facial appearance, chewing, swallowing and language function. Conclusion: Free anterolateral thigh flaps can be used to repair various complex oral and maxillofacial defects.

关 键 词：股前外侧皮瓣 修复重建 皮瓣修薄 穿支 

分 类 号：R739.85[医药卫生—肿瘤] R622.1[医药卫生—临床医学]