胸大肌肌皮瓣在口腔颌面部大面积缺损中的应用探讨.docx

胸大肌肌皮瓣在口腔颌面部大面积缺损中的应用探讨[摘要]目的：探讨在口腔颌面部大面积缺损中使用胸大肌肌皮瓣进行修复重建的临床效果与应用价值。方法：选取我院2010年5月-2013年6月收治的48例口腔颌面部大面积组织缺损患者对其使用胸大肌带蒂肌皮瓣进行修复治疗观察患者治疗后临床效果并评估其应用价值。结果：48例口腔颌面部大面积缺损患者经使用胸大肌肌皮瓣修复治疗后全部成活成活率100%其中2例出现远端坏死经治疗处理后部分成活不影响口腔功能；除1例修复后开口受限达到Ⅱ度、3例下颌骨区段切除其余口腔功能正常患者满意度为89.58%（43/48）。结论：在口腔颌面部大面积缺损的临床修复治疗中使用胸大肌肌皮瓣能够满足缺损面积需要具有良好的修复效果与成活率可有效改善口腔功能患者对修复效果较为满意。[关键词]口腔颌面部；大面积缺损；胸大肌；肌皮瓣修复[中图分类号]R782[文献标志码]A[文章编号]1008-6455（2015）12-0037-03InverstigationonapplicationvalueofpectoralismajormyocutaneousflaptolargedecayoforalandmaxillofacialregionTUXue-song1HUANGWei-dong2GUOTie2HUANGQiu-ming1（1.DepartmentofPharmacyCentralHospitalofXiaoganXiaogan432000HubeiChina；2.DepartmentofStomatologyCentralHospitalofXiaoganXiaogan432000HubeiChina）Abstract：ObjectiveToobserveandanalyzetheclinicaleffectandapplicationvalueofpectoralismajormyocutaneousflaptolargedecayoforalandmaxillofacialregion.Methods48caseswithlargedecayoforalandmaxillofacialregiontreatedinourhospitalfromMay2010toJune2013wereselectedasresearchobjectsandweretreatedwithpectoralismajormyocutaneousflap.Theclinicaleffectofpatientswasobservedandtheapplicationvaluewasevaluated.Results48caseswithlargedecayoforalandmaxillofacialregionsurvivedafterreceivingthetreatmentofpectoralismajormyocutaneousflapandthesurvivalratewas100%inwhichtherewere2caseswithdistalendnecrosiswhichhadnoinfluenceonoralfunction.Therewas1casewithlimitationachievingⅡlevelafterrepairand3caseswithresectionoflowerjawboneexceptforwhichtheoralfunctionsofotherpatientswerenormal.Thesatisfactorydegreeofpatientswas89.58%（43/48）.ConclusionForclinicaltreatmentonlargedecayoforalandmaxillofacialregionusingpectoralismajormyocutaneousflapnotonlycanmeettherequirementofdecayareaandhasgoodrepaireffectandsurvivalratebutalsocanimproveoralfunct