不同形式游离股深动脉蒂嵌合穿支肌皮瓣修复舌癌术后缺损的疗效观察

发布时间：2018-05-25 20:37

  本文选题：股深动脉 + 嵌合穿支肌皮瓣　； 参考：《中国修复重建外科杂志》2017年06期

【摘要】：目的探讨不同形式游离股深动脉蒂嵌合穿支肌皮瓣的临床解剖及其在舌癌术后缺损修复中的应用。方法 2011年4月—2016年1月,采用不同形式股深动脉蒂嵌合穿支肌皮瓣修复44例舌癌术后缺损。男40例,女4例;年龄32~71岁,平均46.3岁。原发舌缘24例,舌腹17例,口底癌累及舌3例。病理类型均为鳞状细胞癌;按国际抗癌联盟(UICC)TNM分期:T4N0M0 16例,T4N1M0 11例,T3N1M0 9例,T3N2M0 8例。病程1~22个月,平均8.6个月。皮瓣切取范围为8.5 cm×4.0 cm~12.0 cm×6.5 cm,肌瓣切取范围为4.0 cm×3.0 cm~7.5 cm×5.0 cm。其中11例采用游离股深动脉蒂嵌合穿支大收肌肌皮瓣,大收肌穿支血管蒂长度为(8.3±0.5)cm;33例采用游离股深动脉蒂嵌合穿支股薄肌肌皮瓣,股薄肌穿支血管蒂长度为(8.1±0.8)cm。大腿内侧供区均直接拉拢缝合。结果术后游离股深动脉蒂嵌合穿支肌皮瓣均顺利成活,创面Ⅰ期愈合;供区切口均Ⅰ期愈合。所有患者均获随访,随访时间12~40个月,平均23.8个月。所有患者再造舌形态良好,舌体活动可,吞咽和语言功能恢复满意,无1例肿瘤局部复发。大腿内侧瘢痕位置隐蔽,仅遗留线状瘢痕。结论游离股深动脉蒂嵌合穿支肌皮瓣可以以不同形式切取,适用于舌癌术后缺损修复。
[Abstract]:Objective to investigate the clinical anatomy of different types of free deep femoral artery pedicled perforator myocutaneous flap and its application in repairing defects after tongue cancer operation. Methods from April 2011 to January 2016, 44 cases of tongue carcinoma were repaired with different types of deep femoral artery pedicle perforator myocutaneous flap. There were 40 males and 4 females, aged 32 to 71 years (mean 46.3 years). There were 24 cases with primary tongue margin, 17 cases with ventral tongue and 3 cases with carcinoma of the floor of mouth. All the pathological types were squamous cell carcinoma, according to the TNM stage of UICC TNM, 16 cases of T4N0M0, 11 cases of T4N1M0 11 cases of T3N1M0 9 cases of T3N2M0 8 cases. The course of disease ranged from 1 to 22 months with an average of 8.6 months. The range of flap removal was 8.5 cm 脳 4.0 cm~12.0 cm 脳 6.5 cm, and that of muscle flap was 4.0 cm 脳 3.0 cm~7.5 cm 脳 5.0 cm. Among them, 11 cases were treated with free deep femoral artery pedicle with chimeric perforator great adductor myocutaneous flap, 33 cases were treated with free deep femoral artery pedicle chimeric perforator myocutaneous flap, and the length of perforator vessel pedicle of thin femoral muscle was 8.1 卤0.8 cm. The medial thigh donor area was closed and sutured directly. Results the free deep femoral artery pedicle chimeric perforator myocutaneous flap survived successfully, and the wound healed at stage 鈪，

本文编号：1934594