1--212块股前外侧肌皮瓣在口腔颌面缺损修复中的应用.docx

1??212块股前外侧肌皮瓣在口腔颌面缺损修复中的应用[摘要]目的探讨游离股前外侧肌皮瓣在口腔颌面部修复重建的价值。方法收集2002年2月―2013年6月间在中南大学湘雅二医院口腔颌面外科住院进行了股前外侧肌皮瓣修复的患者1185例（1212块皮瓣）。记录并统计患者的基本资料、缺损部位、皮瓣的面积及类型、受区血管的处理方法、供区并发症、患者术后生存质量等情况。结果1212块皮瓣成活1176块坏死36块成活率97.0%。皮瓣供区无严重并发症出现。股前外侧肌皮瓣重建口腔颌面部各个部位的缺损后90%以上的患者得到了良好的功能恢复及美观效果。吻合1根静脉与吻合2根静脉相比可以显著地缩短显微操作时间（P=0.0003）。2组的静脉危象发生率、抢救成功率及静脉危象导致的皮瓣坏死率均无统计学差异（P>0.05）。结论股前外侧肌皮瓣组织供应量大可满足口腔颌面部各个部位缺损的修复要求。股前外侧肌皮瓣比其他游离皮瓣更适合用于口腔颌面部缺损修复应作为首选皮瓣。[关键词]股前外侧皮瓣；口腔癌；颌面部缺损[中图分类号]R782.2+4[文献标志码]A[doi]10.7518/hxkq.2015.03.014[Abstract]ObjectiveToexaminethebenefitsofanterolateralthighmyocutaneousflapsinreconstructionoforalandmaxillofacialdefects.MethodsPatientswererecruitedfromFebruary2002toJune2013intheDepartmentofOralandMaxillofacialSurgeryofCentralSouthUniversity.Allpatients（1185patients1212transferredflaps）underwentreconstruc-tivesurgeryemployinganterolateralthighmyocutaneousflaps.Basicinformationforallpatientsincludingdefectsideflapsizeandtyperecipientvesselprocessingmethoddonorcomplicationsandpostoperativequalityoflifewererecordedandstatisticallyanalyzed.ResultsAmongthe1212transferredflaps1176survivedand36showednecrosisforasurvivalrateofabout97.0%.Nocasespresentedwithlocalseriouscomplicationsand90%ofpatientsachievedgoodfunctionalrecoveryandaestheticallyacceptableresultsafterreconstructionoforalandmaxillofacialdefectsatvariouslocationsusinganterolateralthighmyocutaneousflaps.Thetimeforanastomosisofoneveinwassignificantlylessthanthatfortwoveins（P=0.0003）whichindicatedoneveinanastomosiscouldsignificantlyreducetheoperatingtime.Theincidenceofvenouscrisisthesur-vivalrateaftertreatmentandtherateofvenouscrisisresultinginflapnecrosiswerecomparablebetweenthegroups（P>0.05）.ConclusionAnterolateralthighmyocutaneousflapscanbeeasilyobtainedandprovideagood