带蒂肌(皮)瓣修复口腔颌面部组织缺损123例临床分析

目的 :探讨几种带蒂肌 (皮 )瓣移植在口腔颌面部组织缺损修复中的临床效果和适应症。方法 :对1995 .1.-2 0 0 3 .9.间采用带蒂肌 (皮 )瓣移植修复口腔颌面部组织缺损的 12 3例临床资料做回顾性分析 ,包括受区缺损情况、组织瓣的类型、成活情况及术后并发症等多方面。结果 :12 3例中 12 0例为肿瘤切除术后缺损的同期修复 ,3例为放射性颌骨坏死缺损的修复。 12 2例患者安全度过围手术期 ,1例在术后第 2d死于消化道应激性溃疡导致的失血性休克。胸大肌皮瓣 ( 4 0例 )、胸锁乳突肌皮瓣 ( 3 7例 )和颈阔肌皮瓣 ( 3 5例 )为最多采用的组织瓣 ,占全部带蒂组织瓣的 91% ( 112 /12 3 )。移植成功率为 92 .6% ( 113 /12 2 ) ,受区和供区总的并发症发生率为 2 1%。结论 :带蒂肌 (皮 )瓣可以较好地修复口腔颌面部的组织缺损 ,应根据缺损的组织量、部位、缺损范围和全身情况选用不同的带蒂组织瓣

An analysis of 123 cases of defect repair with pedical muscle(skin) flap in oral and maxillofacial region

Objective:To explore the clinical effects and indication of several pedical muscle(skin) flap applied in defect repair in oral and maxillofacial region.Method: The clinical informations of 123 cases of defect repair with pedical muscle(skin) flap in oral and maxillofacial region from January 1995 to December 2003 were analysed retrospectively, including defect site, tissue flap type, suivival situation and complications.Result:120 of 123 cases were the primary repair of defect after excision of tumor, and 3 cases defects were caused by radionecrosis of the jaws. 122 patients tided over perioperation safely, but one patient died of hypovolemic shock caused by stress ulcer. Pectoral major myocutaneous flap(40 cases) was most commonly used, followed by sternocleidomastoid myocutaneous flap(37 cases) and platysma flap(35 cases). The three types ranked 91% in all tissue flaps. The total repair successful rate was 92.6%(113/122). The overall complication rate was 21%.Conclusion:The pedical muscle(skin) flaps can repair the defects in oral and maxillofacial region., but they have some indications respectively. The selection of tissue flaps should depend on the range of defect, site and patient's general state.