双V-Y推进黏膜瓣修复舌部缺损的临床应用  

Clinical application of double V-Y advancement mucosal flap to repair tongue defect

作　　者：卢若煌[1] 王煜林 毛平[2] 甘平平[3] 戴捷[4] 袁力 LU Ruohuang;WANG Yulin;MAO Ping;GAN Pingping;DAI Jie;YUAN Li(Department of Stomatology,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Nursing,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Oncology,Xiangya Hospital,Central South University,Changsha 410008;Department of Head and Neck Surgery/Oncoplastic Surgery,Hunan Cancer Hospital,Changsha 410006;Department of Nuclear Medicine,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院口腔科,长沙410013 [2]中南大学湘雅三医院护理部,长沙410013 [3]中南大学湘雅医院肿瘤科,长沙410008 [4]湖南省肿瘤医院头颈外科/肿瘤整形外科,长沙410006 [5]中南大学湘雅三医院核医学科,长沙410013

出　　处：《中南大学学报（医学版）》2023年第7期1033-1038,共6页Journal of Central South University ：Medical Science

基　　金：湖南省重点研发计划(2018SK2122)。

摘　　要：目的:口腔舌部中小型缺损修复一直是一个难题,游离皮瓣和远位带蒂组织瓣难以满足临床需求,舌瓣是修复舌部中小型缺损的理想选择,然而局部形态不佳等缺点制约了该术式的开展。本研究旨在探讨双V-Y推进黏膜瓣修复中小型舌部缺损的疗效。方法:2019年3月至2022年5月中南大学湘雅三医院口腔科收治15例舌部病变患者,在彻底切除病变后遗留舌部黏膜缺损,于缺损前后方各设计1个V-Y推进黏膜瓣,自表面黏膜逐步向四周切开,保留深部正中肌肉蒂,将2个瓣向缺损中间游离,在缺损中央缝合,随后缝合供区。结果:15例患者双V-Y推进黏膜瓣术后均成活,创口均Ⅰ期愈合。患者术后随访12~22个月,舌部病变无复发,舌部对称满意,口内黏膜瓣菲薄平整,愈合良好,无明显咬舌等现象发生。结论:双V-Y推进黏膜瓣具有设计灵活、制备简单、供区保护良好和血供可靠等优点,是修复舌部黏膜中小型缺损的有效方法之一。Objective:The repair of small-and medium-sized defects in the oral tongue has always been a challenge,and the effect of free flap and distal pedicle flap is still far from satisfactory.Tongue flap is an ideal choice for repairing small-and medium-sized defects.However,the disadvantages such as poor local morphology restricts the development of this operation.This study aims to investigate the efficacy of double V-Y advancement mucosal flap in repair of small-and medium-sized defects of the tongue defect.Methods:The clinical data of 15 patients with tongue defect lesions who were hospitalized in the Department of Stomatology,Third Xiangya Hospital of Central South University from March 2019 to May 2022 were retrospectively analyzed.After the lesions were completely excised,the mucosa and part of the tongue defect were left.One V-Y advancement mucosal flap was designed anteriorly and posteriorly to the defect.The superficial mucosa was incised gradually all around,preserving the deep median muscle tip.The 2 flaps were freed toward the middle of the defect,and the anterior and posterior flaps were sutured together at the middle of the defect,with the donor area directly pulled together and sutured.Results:The double V-Y advancement mucosal flap survived in 15 patients,and the wounds healed at stage I.The postoperative follow-up time was 12−22 months,and the patients had no recurrence,with symmetrical tongue shape,and no traction and deformation in the affected tongue organs.Meanwhile,the intraoral flap was thin and flat,and healed well with the surrounding mucosa,without obvious flap contracture or tongue bite.Conclusion:Double V-Y advancement mucosal flap has the advantages of flexible design,simple preparation,reliable blood supply,and good protection of the donor site,which may be one of the effective methods for repairing small-and medium-sized defects in the anterior tongue mucosa.

关 键 词：双V-Y推进黏膜瓣 舌部缺损 创面修复 

分 类 号：R782[医药卫生—口腔医学]