颏下动脉穿支皮瓣在临床头颈肿瘤修复中的应用  

Application of submental artery perforator flap in head and neck neoplasms repair

作　　者：贾忆莲 李连贺 王洪敏 武卫民 谭福宪 温振雷 王红梅 JIA Yilian;LI Lianhe;WANG Hongmin;WU Weimin;TAN Fuxian;WEN Zhenlei;WANG Hongmei(IThe Postgraduate Training Base of Jinzhou Medical University(Chaoyang Central Hospital),Chaoyang,Liaoning,122000,China;Department of Otolaryngology Head and Neck Surgery,Chaoyang Central Hospital,Chaoyang,Liaoning,122000,China;Department of Stomatology,Chaoyang Central Hospital,Chaoyang,Liaoning,122000,China)

机构地区：[1]锦州医科大学研究生培养基地(朝阳市中心医院),辽宁朝阳122000 [2]朝阳市中心医院耳鼻咽喉头颈外科,辽宁朝阳122000 [3]朝阳市中心医院口腔科,辽宁朝阳122000

出　　处：《中国耳鼻咽喉头颈外科》2023年第11期681-685,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：辽宁省科学技术计划(2019-ZD-0901)。

摘　　要：目的 探讨颏下动脉穿支皮瓣及逆行穿支皮瓣在头颈肿瘤修复中的临床应用。方法 回顾性分析朝阳市中心医院2015年1月~2022年6月收治的23例头颈肿瘤修复患者资料,其中22例顺行颏下动脉穿支皮瓣,1例逆行颏下动脉穿支皮瓣,观察术后皮瓣存活率,皮瓣色泽,功能恢复等结果。结果 23例患者中,1例术后出现皮瓣部分坏死,经剪除坏死组织旷置创面并予以抗炎对症治疗后好转,其余皮瓣未见坏死,恢复良好,血运通畅。手术时间270~595 min,平均时间453.3 min,其中取瓣时间30~60 min,平均取瓣时间为41.7 min。术后病理结果:4例患者发生淋巴结转移,其中右侧颈部淋巴结转移3例,左侧颈部淋巴结转移1例。术后1个月随访,23例患者皮瓣愈合良好,血运通畅,外形恢复良好,功能恢复尚可。结论 颏下动脉穿支皮瓣血供稳定,移植后成活率高,皮瓣轻薄而操作灵活,与头面部皮肤纹理更接近,适用于多部位组织修补,肿瘤安全性高,术后恢复快成本低,是头颈部肿瘤术后组织缺损修复的可靠选择。逆行颏下动脉穿支皮瓣具有解剖基础和临床可行性,可应用于修复头颈颌面部的组织缺损。OBJECTIVE To investigate the clinical application of submental artery perforator flap and reverse submental artery perforator flap in head and neck reconstruction.METHODS The clinical data of 23 patients with head and neck tumor repair admitted to Chaoyang Central Hospital from January,2015 to June,2022 were retrospectively analyzed,including 22 cases of antegrade submental artery perforator fiap and 1 case of retrograde submental artery perforator flap.The postoperative fap survival rate,flap color,and functional recovery were observed.RESULTSAmong the 23 patients,1 patient had partial flap necrosis after operation,which was improved after cutting out necrotic tissue and giving anti-inflammatory treatment.The other flaps had no necrosis and recovered well with unblocked blood supply.The mean operation time was 453.3 min(range:270-595min),and the mean time of flap harvesting was 41.7 min(range:30-60 min).Postoperative pathology showed that 4 patients had lymph node metastasis,including 3 cases of right cervical lymph node metastasis and 1 case of left cervical lymph node metastasis.Postoperative follow-up showed that the faps of 23 patients healed well,the blood supply was unobstructed,the appearance was good,and the function was well.CONCLUSION The submental artery perforator flap has stable blood supply,high survival rate after transplantation,and is thin and flexible to operate.It is more similar to the texture of the head and face skin.It is suitable for multi-site tissue repair,fast postoperative recovery and low cost.The reverse submental artery perforator flap has anatomical basis and clinical feasibility,and can be applied to repair the head,neck and maxillofacial tissuedefectsalso.

关 键 词：头颈部肿瘤 修复外科手术 外科皮瓣 颏下动脉穿支皮瓣 

分 类 号：R739.91[医药卫生—肿瘤]