胸大肌肌皮瓣修复口腔颌面部缺损的并发症──168例临床分析

Clinical analysis on complications of reconstruction of oral and maxillofacial defects with pectoralis major myocutaneous flap

目的：回顾分析胸大肌肌皮瓣修复口腔缺损的并发症，明确并发症发生有关的因素，探讨减少其发生的措施。方法：对1990～1996年间所行168例应用带蒂胸大肌肌皮瓣修复口腔颌面部缺损的病人临床资料进行多元素回归分析。168例患者中，男性120例，女性48例，年龄26～79岁。结果：168例皮瓣中，25例出现不同程度坏死（14．9％）；22例发生瘘管（13．1％）；伤口感染39例（23．2％）。与并发症有关的因素有多种，并发症使住院日明显延长。结论：作者认为切取肌皮瓣时，应避免过偏远，中大面积缺损应配合邻近或游离皮瓣修复。

The reconstruction of oral and maxillofacial defects with pectoralis major myocutaneous flap were performed on 168 patients of oral or maxillofacial malignanttumors from 1990 to 1996. There were 120 males and 48 females,ranging in age from 26to 79. The complications of this approach were analyzed in this paper. Result showedthat the flap necrosis presented in 25 (14. 9%),fistular in 22 (13. 1%) and infection in39 (23. 2% ). We suggested that adopted flap should not be too distant from the defectand systemic diseases should be treated actively which were detrimental to flap survival.