带蒂颏下动脉岛状瓣修复颌面部恶性肿瘤术后软组织缺损  

Application of submental artery island flap in repairing soft tissue defect after oral and maxillofacial malignant tumor surgery

作　　者：王春 赵曦[1] 谭雪梅 雷晓旭 WANG Chun;ZHAO Xi;TAN Xuemei;LEI Xiaoxu(Department of Stomatology,People’s Hospital of Deyang City,Deyang 618000,China)

机构地区：[1]德阳市人民医院口腔科,四川省德阳市618000

出　　处：《组织工程与重建外科》2021年第5期383-385,共3页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：四川省德阳市科技局项目(2018szs074)。

摘　　要：目的观察带蒂颏下动脉岛状瓣修复颌面部恶性肿瘤术后软组织缺损的效果。方法2015年6月至2020年8月,65例颌面部恶性肿瘤患者切除术后采用颏下动脉岛状瓣进行软组织修复,分析皮瓣制备要点、缺损修复的效果及手术的安全性。结果皮瓣平均制备时间(65.44±12.23)min,术后平均住院时间(10.16±3.65)d。65例颏下动脉岛状瓣全部成活,其中有2例发生皮瓣感染,经换药冲洗皮瓣明显好转,未出现坏死。术后随访24个月,56例患者存活且无复发;2例患者发生原发灶局部复发,4例患者发生颈部淋巴结转移;3例患者死亡,均为术后未行放、化疗患者。结论带蒂颏下动脉岛状瓣修复颌面部恶性肿瘤术后软组织缺损,具有制备方便、并发症少、成活率高、术后外形恢复良好等优势,但须警惕有颈部淋巴结转移的可能,对于术前有颈部淋巴结转移的患者应慎重选择。Objective To explore the effect of submental artery island flap in repairing soft tissue defect after oral and maxillofacial malignant tumor surgery.Methods The clinical data of 65 patients with oral and maxillofacial malignant tumor who underwent soft tissue repair using submental artery island flap from June 2015 to August 2020 were retrospectively analyzed.The key points of flap preparation,efficacy of defect repair and safety of surgery were analyzed.Results The average preparation time of flap was(65.44±12.23)minutes,the average postoperative hospital stay was(10.16±3.65)days.All the 65 cases of submental artery island flap survived,including 2 cases of flap infection.The flap was significantly improved after dressing changing and irrigation,without necrosis.Up to 24 months after surgery,56 cases survived without recurrence,2 cases developed local recurrence of primary tumor,4 cases developed cervical lymph node metastasis,and 3 patients died,all of which were patients without postoperative chemoradiotherapy.Conclusion Repair of soft tissue defects after oral and maxillofacial malignant tumor surgery with submental artery island flap has the advantages of convenient preparation,less complications,high survival rate,and postoperative aesthetics,but it is necessary to guard against the possibility of cervical lymph node metastasis,and patients with cervical lymph node metastasis should be carefully selected.

关 键 词：颏下动脉岛状瓣 颌面部 恶性肿瘤 软组织缺损 

分 类 号：R782.2[医药卫生—口腔医学]