游离背阔肌皮瓣临床解剖及其在头颈部巨大缺损修复中的应用  

Clinical anatomy of the free latissimus dorsi myocutaneous flap and its application in the restoration of giant defects of the head and neck

作　　者：钱叶梅 王卫红[1] 朱瑾[1] 何永静[2] 许彪[1] 邹智荣 施延安[1] 罗磊 李静宜 QIAN Ye-mei;WANG Wei-hong;ZHU Jin;HE Yong-jing;XU Biao;ZOU Zhi-rong;SHI Yan-an;LUO Lei;LI Jing-yi(Department of Oral and Maxillofacial Surgery,Affiliated Stomatology Hospital of Kunming Medical University,Yunnan Key Laboratory of Stomatology.Kunming 650106;Department of Plastic Surgery,Second Affiliated Hospital of Kunming Medical University.Kunming 650000;Department of Human Anatomy,School of Basic Medical Science,Kunming Medical University.Kunming 650500,Yunnan Province,China)

机构地区：[1]昆明医科大学附属口腔医院口腔颌面外科,云南省口腔医学重点实验室,云南昆明650106 [2]昆明医科大学第二附属医院整形外科,云南昆明650000 [3]昆明医科大学基础医学院解剖教研室,云南昆明650500

出　　处：《上海口腔医学》2024年第3期269-272,共4页Shanghai Journal of Stomatology

基　　金：云南省卫健委医学领军人才项目(L-201801);云南省省级创新团队项目(202105AE160004);云南省基础研究计划(2019FE001-251)。

摘　　要：目的 :探讨游离背阔肌皮瓣修复头颈部巨大缺损的可行性及修复效果。方法 :在尸体上模拟解剖制备背阔肌皮瓣,使用Image-Pro Plus 6.0软件进行测量,评估修复头颈部巨大缺损的可行性。回顾分析2011年5月—2022年9月使用游离背阔肌皮瓣修复的7例头颈部巨大缺损患者的临床资料,评价其修复效果。结果:尸体标本中制备的背阔肌皮瓣动、静脉血管蒂平均长度分别为(85.5±10.5) mm和(104±4.2) mm,胸背动脉起始外径为(4.03±0.56) mm。7例患者中,5例为头皮缺损,2例为颈部缺损。7例背阔肌皮瓣全部成活,供区无明显术后并发症。结论:背阔肌皮瓣组织量丰富,静脉回流充分,血管蒂长度充足,是修复头颈部巨大缺损的理想肌皮瓣。PURPOSE:To investigate the feasibility and effect of free latissimus dorsi myocutaneous flap in the reconstruction of giant head and neck defects.METHODS:Free latissimus dorsi myocutaneous flap on the cadaver was simulated dissected,and measured by Image-Pro Plus 6.0 to assess the feasibility of repairing giant head and neck defects.Between May 2011 and September 2022,seven patients with giant head and neck defects of different causes repaired with the latissimus dorsi myocutaneous flap were retrospectively analyzed.RESULTS:The diameter of the initiating thoracodorsal artery was(4.03±0.56)mm,and the mean lengths of the arteriolar and venous pedicles of the latissimus dorsi myocutaneous flaps obtained from human specimens were(85.5±10.5)mm and(104±4.2)mm,respectively.Among 7 patients,5 cases had scalp defects,the remaining 2 cases had neck defects.There were no substantial postoperative problems in the donor site,and all seven latissimus dorsi myocutaneous flaps were successfully transplanted.CONCLUSIONS:For the treatment of considerable head and neck deformities,the latissimus dorsi myocutaneous flap is an optimal muscle flap due to its abundance of tissue,enough length of vascular pedicles,and sufficient venous drainage.

关 键 词：背阔肌皮瓣 背阔肌解剖 头颈部巨大缺损 重建 Image-Pro Plus 6.0软件 

分 类 号：R782.2[医药卫生—口腔医学]