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目的探讨血管化游离组织瓣修复口腔颌面—头颈部缺损的应用价值。方法收集4 481例应用血管化游离组织瓣修复重建患者资料,对其构成比、发展趋势、一线组织瓣特点、皮瓣危象发生率与成功率等进行系统分析总结。采用Microsoft Excel(2010 version)软件进行数据的统计学分析。结果共制备4 640例血管化游离组织瓣,平均年龄58.6岁,男女比例1.6∶1,良、恶性比例1∶3。舌(25.1%)、下颌骨(16.0%)、口底(13.4%)、颊(12.7%)缺损修复占总数的67.2%。前臂皮瓣(55.6%)、腓骨组织瓣(13.5%)、股前外侧穿支皮瓣(10.1%)应用占皮瓣总数的79.2%。419例皮瓣危象发生,成功抢救皮瓣305例,皮瓣危象总发生率为9.0%,危象抢救成功率72.8%,皮瓣总成功率达97.5%。结论血管化游离组织瓣成功率高,应用安全可靠;针对不同缺损特点,采用合适组织瓣修复,对患者功能与外形重建具有重要意义;前臂皮瓣、腓骨组织瓣与股前外侧穿支皮瓣为口腔颌面头颈部缺损修复的常用组织瓣。
Objective To investigate the value of vascularized free tissue flap in repairing oral maxillofacial-head and neck defects. Methods A total of 4 481 cases of vascularized free flap were collected and reconstructed. The constituent ratio, development trend, first-line flap characteristics, incidence and success rate of flap crisis were systematically analyzed and summarized. Using Microsoft Excel (2010 version) software for statistical analysis of the data. Results A total of 4 640 vascularized free tissue flaps were prepared, with an average age of 58.6 years. The ratio of male to female was 1.6: 1, and the ratio of benign and malignant was 1: 3. Tongue (25.1%), mandible (16.0%), mouth bottom (13.4%), cheek (12.7%) defect repair accounted for 67.2% of the total. Forearm flaps (55.6%), fibula tissue flap (13.5%), and anterolateral perforator flaps (10.1%) accounted for 79.2% of the total number of flaps. Seventy-one nine hundred and ninety-nine cases of skin flap crisis occurred. 305 cases were successfully salvaged, the total incidence of skin crisis was 9.0%, the success rate of crisis rescue was 72.8% and the total flap success rate was 97.5%. Conclusion The successful rate of vascularized free tissue flap is high, and its application is safe and reliable. Using appropriate tissue flap for different defect characteristics is of great significance to the reconstruction of patient’s function and shape. Forearm flap, fibular tissue flap and anterolateral femoral perforator flap Common oral and maxillofacial head and neck defect tissue flap repair.