薄型腹壁浅动脉皮瓣在修复颊癌术后软组织缺损中的应用  

Application of thin superficial inferior epigastric artery flap in repairing soft tissue defect after buccal cancer

作　　者：高廷益[1] 张凯[1] 王栋 韩瑞 陈永锋[1] 徐涛[1] 吴志刚[1] 廖圣恺[1] 郭振飞 Gao Tingyi;Zhang Kai;Wang Dong;Han Rui;Chen Yongfeng;Xu Tao;Wu Zhigang;Liao Shengkai;Guo Zhenfei(Department of Oral and Maxillofacial Surgery,First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院口腔颌面外科,233004

出　　处：《中华整形外科杂志》2020年第7期784-787,共4页Chinese Journal of Plastic Surgery

基　　金：安徽省高校自然科学研究项目(KJ2018A1005);蚌埠医学院自然科学重点研究项目(BYKY2019017ZD)。

摘　　要：目的探讨薄型腹壁浅动脉皮瓣修复颊癌术后软组织缺损的临床应用效果。方法2018年1月至2019年10月,蚌埠医学院第一附属医院口腔颌面外科对6例行手术治疗的颊癌患者同期行薄型腹壁浅动脉皮瓣修复,男2例,女4例,年龄43~68岁,平均61.5岁。所有患者术前以彩色超声多普勒辅助皮瓣设计,根据受区缺损大小及血管的走行、层次和走向,在Scarpas筋膜层以上切取薄型腹壁浅动脉皮瓣并转移修复颊癌术后软组织缺损,观察皮瓣存活及功能恢复情况。结果6例皮瓣全部成活,腹壁浅动脉皮瓣面积5.0 cm×7.0 cm^7.0 cm×9.0 cm,皮瓣厚度0.5 cm^1.3 cm,平均0.8 cm,血管蒂长度6.0~9.0 cm。其中4例同时吻合腹壁浅静脉和伴行静脉,2例仅吻合腹壁浅静脉。随访3~12个月,平均10个月,颊部外形良好,张口度正常,无明显臃肿,无需二期手术。供区创面遗留线性瘢痕,位置隐蔽,腹壁功能无损伤。结论薄型腹壁浅动脉皮瓣供区损伤小、瘢痕隐蔽、颊部不臃肿,张口度恢复满意,是修复颊癌术后缺损的较好选择。Objective To investigate the clinical effect of thin superficial inferior epigastric artery flaps in repairing soft tissue defects after buccal cancer surgery.Methods From January 2018 to October 2019,6 patients with buccal cancer who underwent surgery were constructed with thin superficial inferior epigastric artery flaps,including 2 males and 4 females,aged 43 to 68 years,with an average of 61.5 years.Doppler ultrasound was utilized of all patients to design flap preoperatively.According to the size of the affected area defect,according to the shape and direction of the blood vessels,a thin superficial inferior epigastric artery flap was elevated above the Scarpas fascia layer and transferred to repair soft tissue defects after buccal cancer surgery.The survival and functional recovery of the flap were observed.Results All 6 flaps survived.The superficial inferior epigastric artery flaps ranged from 5.0 cm×7.0 cm to 7.0 cm×9.0 cm.The thickness of the flaps ranged from 0.5 cm to 1.3 cm,and the average thickness was 0.8 cm.The pedicle length is 6.0-9.0 cm.Four of them anastomosed to the superficial inferior epigastric veins and companion vein,2 cases only anastomized superficial inferior epigastric veins.The follow-up period ranged from 3 to 12 months,with an average of 10 months.The cheek shape was good,the mouth opening was normal,there was no obvious bloating,and no secondary surgery was required.Linear scars were left on the donor site,with concealed location and no impairment of abdominal wall function.Conclusions The donor site of the thin superficial inferior epigastric artery flap is small,the scar is concealed,the cheek is not bloated,and the opening degree of mouth is satisfactory.It is a good choice for reconstructing postoperative defect of cheek cancer.

关 键 词：腹壁浅动脉 外科皮瓣 颊癌 

分 类 号：R739.8[医药卫生—肿瘤]