口腔颌面部43例吻合血管的游离组织瓣应用分析

Analysis of 43 Free Flaps Transfer in Oral and Maxillofacial Region

目的 探讨吻合血管的游离组织瓣移植在口腔颌面部缺损修复中的应用价值。方法 对中山大学附属第二医院口腔颌面外科 2 0 0 0年 12月～ 2 0 0 3年 9月完成的 4 3例吻合血管的游离组织瓣移植患者的临床资料进行分析 ,包括临床病理诊断、手术后的缺损情况、所采用组织瓣的类型、受区血管和吻合方式、组织瓣成活情况及术后并发症等。结果 移植成活率为 97.7% (42 / 4 3)。出现血管危象 6例 ,5例抢救成功 ,1例失败。术后口腔和颈部创面均Ⅰ期愈合 ,无涎瘘、乳糜漏、口底颌下瘘和感染等并发症发生。组织瓣移植后外形和功能恢复良好。结论 吻合血管的游离组织瓣的运用拓宽了口腔颌面部缺损修复方式的选择范围 ,运用得当可以获得较高成功率。

Objective To discuss the clinical application and effects of free flaps transfer for defects in oral and maxillofacial region. Methods 43 free flaps transfer for defects in oral and maxillofacial region from December 2000 to September 2003 were retrospectively analyzed, including the clinical pathological diagnosis, defect description and site, flap types, recipient vessel and anastomotic methods, survival description and complications. Results The total successful transfer rate reached 97.7%. After the operations, 6 flaps developed vascular crisis, and 5 of them were successfully salvaged. The surgical parts of the oral cavity and neck healed up, with no salivary fistula, chylorrhea, submandibular fistula and infection. The shapes and functions regained after transfer. Conclusion Free flaps transfer supplies more procedures for defect repair in oral and maxillofacial region. Reasonable application could get high successful transpfer rate.