CT血管造影辅助设计的个性化股前外侧皮瓣在修复舌癌术后缺损中的应用

发布时间：2018-11-22 17:05

【摘要】：目的:探讨CT血管造影(CTA)定位股前外侧皮瓣穿支血管辅助设计的个性化股前外侧皮瓣(ALTF)在舌癌术后缺损修复中的效果。方法:纳入舌鳞状细胞癌患者21例,术前采用CTA定位患者股前外侧皮瓣穿支血管并根据检查结果模拟设计个性化的ALTF,术中应用ALTF行软组织缺损重建修复。结果:21例手术均顺利完成,术中所见血管走行与术前CTA显示均一致;切取皮瓣面积6.0 cm×5.0 cm~11.0 cm×8.5 cm;其中20例皮瓣存活,2例皮瓣发生血管危象,经手术探查后,1例皮瓣恢复正常,1例皮瓣未能抢救成功,皮瓣坏死。术后随访6~36月,1例患者术后18个月死于肿瘤远处转移,其余患者均无瘤存活,移植皮瓣存活情况良好,舌外形、咀嚼功能、吞咽功能、语言功能恢复满意。结论:术前CTA可精确定位股前外侧皮瓣穿支血管,利用CTA辅助设计的个性化股前外侧皮瓣修复软组织缺损可取得满意的效果。
[Abstract]:Objective: to investigate the effect of CT angiography (CT) (CTA) localization of the perforating branch of anterolateral femoral flap (ALTF) in repairing the defect after tongue cancer operation. Methods: Twenty-one patients with tongue squamous cell carcinoma were included. The perforating vessels of anterolateral femoral flap were located by CTA before operation. According to the results, personalized ALTF, was designed and ALTF was used to reconstruct the soft tissue defect. Results: all the 21 cases were successfully completed, and the vascular pattern was consistent with the CTA display before operation, and the area of the skin flap was 6.0 cm 脳 5.0 cm~11.0 cm 脳 8.5 cm;. The flap survived in 20 cases, and vascular crisis occurred in 2 cases. After surgical exploration, 1 case returned to normal, 1 case failed to rescue the flap, and the flap necrosis. After 6 ~ 36 months follow-up, one patient died of distant metastasis of the tumor 18 months after operation. The other patients survived without tumor. The flap survived well, and the shape of tongue, masticatory function, swallowing function and speech function recovered satisfactorily. Conclusion: preoperative CTA can accurately locate perforating vessels of anterolateral femoral flap, and CTA aided individualized anterolateral femoral flap can be used to repair soft tissue defects.
【作者单位】：西南医科大学附属口腔医院口腔颌面外科西南医科大学附属口腔医院口颌面修复重建和再生实验室;
【基金】：国家自然科学基金(编号:81371125) 四川省科技厅项目(编号:2014JY0044) 四川省教育厅项目(编号:10-ZB030) 泸州市科技局项目[编号:2016-R-70(14/24)]
【分类号】：R739.86

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