游离腓骨肌皮瓣修复下颌骨缺损的临床应用及其治疗效果评价

发布时间：2018-02-02 05:03

本文关键词： 腓骨瓣下颌骨缺损颌骨重建皮瓣　出处：《吉林大学学报(医学版)》2014年06期 　论文类型：期刊论文

【摘要】：目的:探讨血管化游离腓骨肌皮瓣修复下颌骨缺损的方法,评价其成活率和修复效果。方法:选择采用血管化游离腓骨肌皮瓣修复颌骨缺损患者16例,其中男性12例,女性4例,年龄24~66岁,平均年龄45.2岁。患者选择条件为肿瘤破坏颌骨需行颌骨部分或全部切除,有愿望修复重建下颌骨,且全身状态能够耐受长时间手术者。同时进行原发肿瘤切除及血管化游离腓骨肌皮瓣的切取,根据缺损的部位及大小塑形腓骨,重建钛板固定,修复重建下颌骨。术后通过观察皮瓣的颜色、质地、皮温等确定皮瓣是否成活,并通过手术前后患者的面像照片及X线片评价修复重建的效果。结果:16例患者皮瓣全部成活,受区无严重并发症,供区主要并发症为皮肤紧张,创口裂开,经换药自行愈合;手术前后面像照片及X线片经2人以上双盲评价认为下颌骨修复效果良好。结论:游离腓骨肌皮瓣成活率高、修复下颌骨效果良好,可以满足各种类型下颌骨缺损修复的需要。
[Abstract]:Objective: to explore the method of repairing mandibular defect with vascularized free fibula myocutaneous flap and evaluate its survival rate and effect. Methods: 16 cases of mandibular defect were repaired with vascularized free fibula myocutaneous flap. There were 12 males and 4 females, aged 24 to 66 years, with an average age of 45.2 years. At the same time, the primary tumor resection and vascularized free fibula myocutaneous flap were removed, and the titanium plate was fixed according to the site and size of the defect and the shape of the fibula. Repair and reconstruct mandible. After operation, observe the color, texture, skin temperature and so on to determine whether the flap survived or not. Results all the 16 cases of skin flap survived, and there were no serious complications in the recipient area. The main complications of donor area were skin tension and fracture. Healing by changing medicine; The results showed that the mandibular repair effect was good by double blind evaluation before and after operation. Conclusion: the free fibula myocutaneous flap has a high survival rate and a good mandibular repair effect. It can meet the needs of various types of mandibular defect repair.
【作者单位】：吉林大学口腔医院口腔颌面外科;
【基金】：吉林省发改委科研基金资助课题(2010)
【分类号】：R782.2
【正文快照】： 下颌骨左右对称,是口腔颌面部的重要器官。下颌骨是完成正常咀嚼、吞咽及语音功能的重要保障;另外,下颌骨是面下1/3形态的骨性支撑,与颜面美有密切关联。由于肿瘤、外伤等术后造成的下颌骨缺损严重影响人的咀嚼、吞咽及发音等口腔功能,也严重破坏颜面美观,所以下颌骨的修复重

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