皮瓣及肌皮瓣移植感觉功能恢复过程的临床研究

Clinical study on the recovery of sensory function in tissue flaps repairing the defect of oral and maxillofacial region

非神经化皮瓣及肌皮瓣29例，神经化皮瓣4例。非神经化瓣的感觉功能从术后3月起逐渐恢复，依次是痛觉、触压觉、温度觉和二点分辨觉。恢复从边缘向中央逐渐进行，术后2～3年，约65．5％的组织瓣感觉功能取得了较好恢复，此时痛觉、触压觉、温度觉和二点分辨觉的恢复率分别为64．7％、64．7％、53．0％和23．5％，其中，皮瓣感觉恢复较肌皮瓣为好。神经化皮瓣感觉再生恢复明显优于非神经化皮瓣。组织瓣的感觉来源于其周围和深层组织的神经末梢的再生，任何影响再生神经末梢数量和质量的因素均会影响组织瓣感觉功能的恢复。

The recovery of sensibility in 29 cases non-neurolorized tissue flaps and 4 cases neurolorized flaps have been studied clinicaly.The results showed that: the sensory function started to return from 3 months after operation and recovered gradually.Pain sensibility recov-ered first,followed by tactile,thermal and two-point discrimination sensibility. The recovery usually occurred from edge to centre of the flap 2~3 years after operation,about 65.5% non-neurolorized flaps obtained good recovery of sensibility.The recovery rate of pain,tactile,ther-mal and two-point discrimination sensibility was 64.7%, 64.7%, 53.0% and 23.5% respec-tively. Flaps recovered better than myocutaneous flaps. The recovery of sensilibility of the neu-rolorized flaps occurred early and quickly. All 4 cases obtained excellent sensory recovery in-cluding two-point discrimination sensibility. The results suggest that:the sensory function of tissue flaps come from not only surrounding, but also deep tissues,any factor that can cause decrease of quality and quantity of regenerated nerve endings will inhibit flap from recovering its sensory function.