应用游离腓骨皮瓣修复下颌骨缺损的研究

目的探讨应用游离腓骨皮瓣移植修复下颌骨缺损的临床效果。方法收集我科收治的90例下颌骨缺损患者的临床资料,按不同的手术修复方法分为两组,48例应用吻合血管的游离腓骨皮瓣修复为观察组,42例采取钛板固定治疗为对照组,观察比较两组患者疗效。结果两组手术均较成功,患者12天之内均顺利出院,观察组患者治疗总有效率为97.9%,对照组治疗总有效率为85.7%,观察组疗效显著优于对照组,差异有统计学意义（P〈0.05）;观察组术后3周下肢行血管彩色多普勒检查示血流通畅,术后3-12个月随访所有患者,行走较正常,无一例发生皮瓣坏死,对照组术后3例发生钛板松动。结论应用吻合血管的腓骨皮瓣修复下颌骨缺损效果可靠,且术后并发症少,预后好,值得相关人员参考和使用。

Clinical Effect of Free Fibular Flap Transplantation for Repair of Mandible Defect

Objective To explore the clinical effects of free fibular flap transplantation for repair of mandible defect. Methods 90 patients with mandible defect were classified into two groups according to surgical repair methods.48 cases were treated with vascular anastomosis dissociation fibular flap as observation group,other 42 cases were treated with titanium plate fixation as control group,and the therapeutic effect was compared between the two groups.Results The surgery was successful and all cases were discharged within 12 days.The total effective rates of observation group and control group were 97.9% and 85.7%,respectively,and there was statistically significant between the two groups（P〈0.05）.Color doppler examination showed unobstructed blood flow in lower limb vessels 3 weeks after surgery in observation group,all patients walked normally and no one occurred skin flap necrosis in postoperative 3-12 months follow-up.However,3 cases occurred titanium plate loose after operation in control goup.Conclusion Vascular anastomosis fibular flap to repair mandible defect is a reliable,less postoperative complications,better prognosis method,and worthy to be used widely.