两种游离皮瓣在口腔颌面部恶性肿瘤术后缺损修复中的应用

发布时间：2018-12-06 17:56

【摘要】：目的探讨前臂皮瓣和股前外侧皮瓣两种游离皮瓣在口腔颌面部恶性肿瘤切除术后组织缺损修复中的应用价值。方法对该院口腔颌面外科2011年1月至2012年12月收治的经病理确诊的口腔颌面部恶性肿瘤患者53例,TNM分期为T2N0M0~T4N3M0,均行原发灶扩大切除、颈淋巴清扫术加游离皮瓣同期修复术,其中前臂皮瓣修复27例,股前外侧皮瓣修复26例。前臂皮瓣面积最小为3cm×4cm,最大6cm×8cm;股前外侧皮瓣面积最小4cm×6cm,最大8cm×13cm。结果前臂皮瓣成活率为92.59%(25/27),股前外侧皮瓣成活率为96.15%(25/26),两种皮瓣总成活率为94.34%。术后随访2~24个月,50例患者面部外形和功能恢复均良好。前臂皮瓣修复患者中有3例女性患者手臂供区瘢痕明显,2例男性患者供区手掌虎口感觉消失;股前外侧皮瓣修复患者中有1例女性患者大腿供区瘢痕明显,所有患者下肢运动功能未受明显影响。结论前臂皮瓣和股前外侧皮瓣均是口腔颌面部恶性肿瘤术后组织缺损的理想皮瓣。由于前臂皮瓣血管恒定和管径大,易于吻合,更适合初学者采用,而股前外侧皮瓣供区创面可直接拉拢缝合,不需植皮,同时供区创口也比前臂皮瓣更隐蔽。
[Abstract]:Objective to evaluate the value of forearm flap and anterolateral femoral flap in the repair of tissue defect after resection of oral and maxillofacial malignant tumors. Methods from January 2011 to December 2012, 53 patients with malignant tumor of oral and maxillofacial region were treated in our hospital from January 2011 to December 2012. The TNM stage was T _ 2N _ 0M _ 0 and T _ 4N _ 3M _ 0. All patients were treated with expanded resection of primary lesions, neck dissection and simultaneous repair of free flaps. There were 27 cases with forearm flap and 26 cases with anterolateral femoral flap. The minimum area of forearm flap was 3cm 脳 4 cm, the maximum was 6cm 脳 8 cm, and the area of anterolateral femoral flap was the smallest of 4cm 脳 6 cm and the maximum of 8cm 脳 13 cm. Results the survival rate of forearm flap was 92.59% (25 / 27) and that of anterolateral femoral flap was 96.15% (25 / 26). After 2 to 24 months follow-up, 50 patients recovered well in facial shape and function. In 3 cases of forearm flap repair, the scar of donor area of arm was obvious in 3 cases of female, and the sensation of palmar tiger mouth in donor area of 2 cases of male patients disappeared. One female patient with anterolateral femoral flap had obvious scar in the thigh donor area, and the motor function of lower extremity was not significantly affected in all the patients. Conclusion both forearm flap and anterolateral femoral flap are ideal flap for postoperative tissue defect of oral and maxillofacial malignant tumors. The forearm flap is more suitable for beginners because of its constant blood vessel and large diameter, which is more suitable for beginners. The donor area of the anterolateral femoral flap can be closed and sutured directly without skin grafting, and the wound of the donor area is more concealed than that of the forearm flap.
【作者单位】：重庆医科大学附属第一医院口腔颌面外科;
【分类号】：R739.8

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