吉林大学学报(医学版)

• 基础研究 • 上一篇    下一篇

游离腓骨肌皮瓣修复下颌骨缺损的临床应用及其治疗效果评价

孙 宾,于子莹,邵海峰,安继平,张 伟   

  1. 吉林大学口腔医院口腔颌面外科,吉林  长春  130021
  • 收稿日期:2014-05-30 出版日期:2014-11-28 发布日期:2015-01-18
  • 通讯作者: 张 伟(Tel: 0431-85579386,E-mail: zhangwei_i_00@163.com) E-mail: zhangwei_i_00@163.com
  • 作者简介:孙 宾(1982-),男,甘肃省天水市人,主治医师,医学硕士,主要从 事口腔颌面肿瘤及软硬组织缺损修复的研究。
  • 基金资助:

     吉林省发改委科研基金资助课题(2010)

Clinical application and evaluation on therapeutic effects of 
 mandibular reconstruction with free fibula muscle flaps

SUN Bin,YU Zi-ying,SHAO Hai-feng,AN Ji-ping,ZHANG Wei   

  1. Department of Oral and Maxillofacial Surgery,Stomatology Hospital,Jilin University,Changchun 130021,China
  • Received:2014-05-30 Online:2014-11-28 Published:2015-01-18

摘要:

目的:探讨血管化游离腓骨肌皮瓣修复下颌骨缺损的方法,评价其成活率和修复效果。方法:选择采用血管化游离腓骨肌皮瓣修复颌骨缺损患者16例,其中男性12例,女性4例,年龄24~66岁,平均年龄45.2岁。患者选择条件为肿瘤破坏颌骨需行颌骨部分或全部切除,有愿望修复重建下颌骨,且全身状态能够耐受长时间手术者。同时进行原发肿瘤切除及血管化游离腓骨肌皮瓣的切取,根据缺损的部位及大小塑形腓骨,重建钛板固定,修复重建下颌
骨。术后通过观察皮瓣的颜色、质地、皮温等确定皮瓣是否成活,并通过手术前后患者的面像照片及X线片评价修复重建的效果。结果:16例患者皮瓣全部成活,受区无严重并发症,供区主要并发症为皮肤紧张,创口裂开经换药自行愈合;手术前后面像照片及X线片经2人以上双盲评价认为下颌骨修复效果良好。结论:游离腓骨肌皮瓣成活率高、修复下颌骨效果良好,可以满足各种类型下颌骨缺损修复的需要。

关键词: 腓骨瓣, 下颌骨缺损, 颌骨重建, 皮瓣

Abstract:

Objective To investigate the application of vascularized free fibula flaps in reconstruction of mandibular defect,and to evaluate the survival rate and re
pair effect of the method.Methods 16 patients with mandibular tumor,having a desire to reconstruct mandible,and their systemic state could tolerate the long time operation,were selected to reconstruct mandibular defect by vascularized fibula flaps,of which 12 were male,4 female,aged 24-66 years old,average 45.2 years old.The resection of primary tumor and free fibula flaps were simultaneously conducted,then the  fibular flaps were shaped according to the defect location and size of the mandible,and were fixed with reconstructive titanium plate for repair and reconstruction of mandible.The survival of flaps was determined by skin color,texture,and skin temperature of the flaps.The reconstruction effects were evaluated through the patients’ surface like photos and X-ray picture of mandible before and after operation.Results All of flaps were survived and no serious complications were found.The complications of the supplied sites were skin tension and wound dehiscence,which were healed by dressing.The mandibular reconstruction effects were good through 2 or more persons’ double blind evaluation.Conclusion Free fibula flaps have high survival rate and good results in   mandibular reconstruction,and they can meet the needs of various types of mandibular defect repair.

Key words:  , fibula flap, mandibular defect, mandibular reconstruction, flaps

中图分类号: 

  • R782.2