摘要：  目的：总结游离组织瓣在口腔颌面部软、硬组织缺损修复中的应用及提高其成功率的经验。方法：2001—2011年（10年）期间，我院行游离组织瓣修复口腔颌面部缺损的病例共计183例，其中前臂皮瓣91例，腓骨复合组织瓣78例，股前外侧皮瓣14例，用于修复舌、颊、腭、口底、上颌骨、下颌骨等部位缺损，回顾性分析其成活率及术后并发症。结果：179块组织瓣成活，总成活率为97.8%，失败率为2.2%。其中前臂皮瓣成活率为96.7%，腓骨复合组织瓣为98.7%，股前外侧皮瓣为100%。结论：前臂皮瓣是口腔颌面部软组织缺损修复的首选皮瓣，股前外侧皮瓣只有在大范围缺损时使用，对于上、下颌骨缺损均可采用腓骨复合组织瓣修复。 术后1周内监测皮瓣，及时发现血管危象并手术探查处理，是保证游离组织瓣成活的关键。

关键词:  , 游离组织瓣；口腔颌面部缺损；重建修复

Abstract: Objective: To summarize the clinical experience applying free tissue flap to repair the oral and maxillofacial defects. Methods: From 2001 to 2011, 183 patients treated with vascularized free flap were involved in this retrospective study, which were included 91 free radial forearm flap, 78 free fibular flap, 14 anterior-lateral thigh flap． These flaps were used to reconstruct the defects of the tongue, palate, cheek, floor of month, maxilla and mandible. The free flap survival rate and postoperative complications were evaluated. Results: The success rate of free flap was 97.8%. The flap crisis rate was 2.2%. Survival rate of radial forearm flap was 96.7%, fibular flap was 98.7%, and anterior-lateral thigh flap was 100%. The forearm flap was the most common selected soft tissue flap in reconstruction of the defect. Anterior-lateral thigh flap was often used in reconstruction of combined defects. Maxilla and mandibula reconstruction only used fibular flap. Conclusions: Reconstruction with free tissue flap afforded the great possibility for oral maxillofacial tumor resection.

Key words: free flap, oral and maxillofacial defect, reconstruction

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• R782.4