髂骨复合瓣移植供区并发症的临床研究

CLINICAL STUDY ON DONOR SITE COMPLICATIONS FOLLOWING ILIAC CREST COMPOSITE FREE FLAPS TRANSFER

目的：报道切取旋髂深动脉（ＤＣＩＡ）髂骨复合瓣移植供区并发症前瞻性临床研究结果。方法：３８例下颌骨缺损患者共进行４０例ＤＣＩＡ髂骨复合瓣移植，对供区并发症及感觉、运动功能障碍进行手术前后连续追踪评价。结果：供区疼痛，感觉与步态障碍为术后普遍而暂时的并发症；伤口迁延不愈、腹疝、股神经麻痹等并发症发生率较低；供区长期痛可能与神经嵌压及牵拉损伤有关。结论：ＤＣＩＡ髂骨复合瓣移植供区并发症是可以接受的，但应严格掌握手术指征。

Objective: To report the prospective results on donor site complications of iliac crest composite free flaps (ICCFF) transfer. Methods: 38 patients with mandibular defects had undergone a total of 40 ICCFF transfers, donor site complications and sensory changes and gait disturbanles were prospectively assessed during preoperative and postoperative following. Results: donor site pain, sensory changes and gait disturbanles occurred frequently, Most of patients could recover during 6 months to 1 year. Major complications such as delayed healing, incisional hernia and femoral neuropathy were infrequently encountered. long term neuralgia of donor sites possibly ralated to nerves entrapment. Conclusion: in general, donor sites complications on ICCFF transter were found to be acceptable. Emphasis must be placed on operative indications and operating techniques.