《Journal of Oral and Maxillofacial Surgery》

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ZHOU Ting, SUN Gou-wen, WEN Jian-min
  

  1. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, School and
    Hospital of Nanjing University, Nanjing 210008, Jiangsu Province, China
  • Online:2017-10-28 Published:2019-03-26

股前外侧皮瓣与前臂皮瓣修复颊癌术后缺损的临床效果观察

周婷,孙国文,文建民   

  1. 南京大学医学院附属口腔医院·南京市口腔医院口腔颌面外科,江苏   南京   210008
  • 通讯作者: 孙国文,主任医师. E-mail: guowensun@hotmail.com
  • 作者简介:周婷(1982—),女,江苏人,主治医师,硕士研究生. E-mail: ztkouqiang@aliyun.com
  • 基金资助:
    江苏省临床医学科技专项项目(BL2013005);江苏省卫生厅课题项目(H201441)

Abstract:

Objective: To compare and discuss the clinical outcome of Forearm Skin Flap and lateral Femoral Skin Flap in Buccal Defects Restoration. Methods: From January 2013 to December 2017, 49 patients were retrieved and retrospectively reviewed, including 23 cases restored by forearm flap, and 26 cases by femoral anterolateral flap. After 3~36 months, the clinical curative effect was observed and compared. Results: In 23 forearm flap cases, postoperative blood vessel thrombosis occurred in one case, and was completely subsided  after the salvage measures,the successful rate of transplant was 100%. In 26 cases with femoral anterolateral flap,postoperative vessel thrombosis occurred in 4 cases. And after salvage operative exploration, 2 flaps were  saved , the other 2 flaps terminated in ischemic necrosis. The successful rate of transplant was 92.3%. The mean follow-up period was 18.5 months (3-36 months). Conclusions: The forearm skin flap is preferable for the restoration of anterior  or cheilobuccal region defects, and the femoral anteriolateral flap represents a very good choice for the reconstruction of buccal perforation defect.

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摘要:

 目的:探讨颊癌扩大切除后不同缺损区域采用不同游离皮瓣修复的临床效果。方法:选择2013-03—2017-03本院收治的49例颊癌术后行颊部缺损修复治疗的患者作为研究对象,其中23例患者采用前臂皮瓣进行修复,26例患者采用股前外侧皮瓣进行修复治疗,对2组患者手术后临床效果及供区恢复情况进行分析。结果:前臂皮瓣组皮瓣存活率100%,其中1例静脉血栓,经抢救后成活。股前外侧皮瓣组术后皮瓣存活率92.3%,其中4例皮瓣危象,1例静脉血栓,1例血肿,经抢救均成活,2例完全坏死。随访时间为3~36个月,平均18.5个月。结论:前臂皮瓣对于前颊、唇颊缺损修复效果较好,股前外侧皮瓣适用于后颊、洞穿、累及上下颌骨缺损修复,针对不同颊部区域的缺损,选用合适的皮瓣修复可获得满意的临床效果。

关键词: 前臂皮瓣, 股前外侧皮瓣, 颊癌, 颊部缺损, 临床效果

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