下颌骨节段性缺损541例临床回顾性研究

A retrospective study of 541 cases with segmental resection of mandible

目的对下颌骨节段性缺损患者临床特点和治疗方法进行回顾和分析,为下颌骨修复重建提供理论依据和指导。方法分析541例下颌骨节段性缺损患者的一般情况、下颌骨缺损原因、缺损部位、修复重建方法及并发症。结果541例下颌骨缺损中,肿瘤是导致缺损的主要原因;缺损中以不超过中线的一侧缺损为主要类型(426例,占下颌骨体部缺损的82·4%)。修复方法包括直接关闭创口、单纯软组织瓣修复、单纯钛板修复、钛板+软组织瓣修复和骨瓣修复,其中骨瓣修复(234例)、钛板+软组织瓣修复(103例)及单纯软组织瓣修复(142例)是最常用的修复方法。最常见的局部并发症是感染或瘘道(55例),感染率10·2%。结论本组下颌骨缺损患者的年龄分布与以往的有关报道相似,肿瘤是缺损主要原因,下颌骨体部是最容易累及的缺损部位,大部分缺损是包含软组织缺损的下颌骨复合缺损。在诸多修复方法中,血管化的自体骨组织瓣移植已经成为下颌骨重建的主要方法。口腔颌面肿瘤患者在骨组织重建的同时,相邻软组织的重建应引起足够重视。

Objective To evaluate the epidemiology and treatment of segmental defect of mandible,Methods Atotal of 541 patients were evaluated retrospectively.The character of the mandibular defect and method of reconstruction were analyzed.Results The majority of segmental defect of mandible were found in 40-70 years old males and the leading cause was tumor.The reconstruetion methods included soft flap,reconstruction plate and bone grafts.The main complications were infection and fistula,Conclusions Tumor was the main cause of segmental resection of mandible,which occurs mainly in adult males.The body of the mandible was often involved.Vascularized bone grafts wrer the main methods in reconstruction of mandible.