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目的探讨非血管化肋、髂骨移植在下颌骨节段截除术后Ⅰ期重建中的效果。方法 2004-2012年为16例因骨良性病变导致下颌骨严重破坏者行下颌骨节段截除术后缺损,取自体肋、髂骨游离移植Ⅰ期重建。结果手术切口均Ⅰ期愈合,随访1~24个月,远期并发瘘道及植骨坏死各1例,颌面下份外观及咬合咀嚼功能基本满意,对半侧下颌骨缺损修复病例相对略差但能维持颜面轮廓及进食。结论非血管化肋、髂骨游离移植在下颌骨节段截除术后Ⅰ期重建中手术操作简单,无需血管吻合技术,只要选择好病例适应证、注意手术技巧即能获得较为满意的疗效,在条件相对较差的基层医院仍是修复下颌骨缺损的一种理想方法。在外观及咬合恢复方面,髂骨移植优于肋骨,骨缺损范围大者略差。
Objective To investigate the effect of non-vascularized rib and iliac bone graft in reconstruction of stage Ⅰ reconstruction of mandibular segment. Methods From 2004 to 2012, 16 cases of severe mandibular destruction led to mandibular reconstruction. Results All the incisions healed in the first stage. All the cases were followed up for 1 ~ 24 months. One case had long-term fistula and bone necrosis. The appearance of the maxillofacial region and masticatory function were basically satisfactory. Poor but can maintain facial contour and eating. Conclusion The non-vascularized rib and iliac bone graft in the reconstruction of mandibular segmental resection stage Ⅰ operation is simple, without vascular anastomosis, as long as the choice of a good case indication, pay attention to the surgical skills that can obtain more satisfactory results in the Grassroots hospitals with relatively poor conditions are still an ideal method of repairing mandibular defects. In terms of appearance and occlusal recovery, iliac graft is superior to the rib, the larger the range of bone defects is slightly worse.