游离上臂外侧皮瓣修复舌癌患者术后软组织缺损的临床应用

发布时间：2018-05-27 14:37

本文选题：舌肿瘤 + 软组织软损　；参考：《吉林大学学报(医学版)》2017年02期

【摘要】：目的:探讨游离上臂外侧皮瓣修复舌癌患者术后软组织缺损的方法,评价其成活率和修复效果。方法:选择舌癌术后软组织缺损应用游离上臂外侧皮瓣修复患者10例,其中男性7例,女性3例,年龄45~67岁,平均年龄52.1岁。患者选择条件为舌癌术后单纯软组织缺损,接受修复重建术且全身情况耐受长时间手术者。患者先进行颈部淋巴结清扫和舌癌根治性切除,再根据缺损部位及缺损大小,设计切取皮瓣,修复重建舌缺损部位。术后观察皮瓣的成活情况,并根据患者修复术后舌的形态、大小、体积和舌的运动情况等评价修复效果。结果:上臂外侧皮瓣解剖稳定,制备简单,供区瘢痕隐蔽,上肢活动及感觉无异常;10例患者皮瓣全部成活,创口一期愈合,舌体形态、大小和质地达到满意,舌体运动无明显受限制,修复后患者语音和咀嚼肌吞咽功能良好,未受明显影响。结论:上臂外侧皮瓣成活率高,修复舌缺损后舌体外形功能良好,是理想的修复舌癌术后软组织缺损的游离皮瓣。
[Abstract]:Objective: to explore the method of repairing soft tissue defect of tongue cancer patients with free lateral upper arm flap and evaluate its survival rate and effect. Methods: 10 patients with soft tissue defect after tongue cancer operation were treated with free upper arm lateral flap, including 7 males and 3 females, aged 45 to 67 years, with an average age of 52.1 years. The patients were selected as simple soft tissue defects after tongue cancer surgery, patients undergoing reconstruction and systemic condition enduring long time operation. The patients underwent neck lymph node dissection and radical resection of tongue cancer, and then the flap was designed according to the defect site and the size of the defect to repair and reconstruct the tongue defect. The survival of the flap was observed, and the repair effect was evaluated according to the shape, size, volume and movement of the tongue. Results: the lateral upper arm flap was stable in anatomy, simple in preparation, concealed in donor scar, survived in all the 10 patients with upper limb movement and no abnormal sensation, and healed at the first stage. The shape, size and texture of tongue body were satisfactory. The tongue-body movement was not significantly restricted, and the speech and masticatory muscle swallowing were not significantly affected after repair. Conclusion: the lateral upper arm flap has high survival rate and good shape function after repairing tongue defect. It is an ideal free flap for repairing soft tissue defect after tongue cancer operation.
【作者单位】：吉林大学口腔医院口腔颌面外科;
【基金】：吉林省财政厅直厅局项目资助课题(5139073431)
【分类号】：R739.86

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