上颌骨及面中份缺损的显微外科修复

Preliminary Study on Microsurgical Reconstruction of Maxillary and Midfacial Defect

[目的]研究应用游离组织瓣行上颌骨缺损修复的方法和适应证。[方法]对1999年7月至2001年1月期间连续完成的30例应用游离组织瓣行上颌骨缺损修复的病例作回顾性研究 ,分析上颌骨缺损的范围、所采用组织瓣的类型、受区血管、组织瓣成活及术后并发症的发生情况 ,并分析应用游离组织瓣行上颌骨缺损修复的适应证和可行性。[结果]30例患者游离组织瓣均获得成活 ,成功率为100%。受区和供区总的并发症发生率为23.3% ,除了早期的3例供区并发症外 ,其余的并发症均不严重 ,未造成明显的后果 ,吸烟、饮酒、放疗和年龄(高龄和儿童)等均非影响手术成功的重要因素。[结论]应用游离组织瓣行上颌骨缺损修复安全可靠 ,成功率高 ,且有利于改善患者术后的功能和外形 ,值得进一步研究和应用 ,但应严格掌握适应证 ,并根据不同缺损的具体特点选择合适的游离组织瓣。

To analyse the rationale and feasibility of maxillary reconstruction with free flaps.Thirty consecutive cases of maxillary reconstruction with free tissue from May 1999 to January 2001 were reviewed retrospectively. Data concerning the operation included defect size and location,stage and histology of tumor,flap type,recipient vessel and complications.Of the 30 cases,all the flaps survived with the overall success rate of 100%.The overall complication rate was 23.3%.Besides two hernia and one skin graft loss in our earlier cases,all the complications were minimal and neglectable.[Conclusion]Maxillary reconstruction with free tissue transfer is safe and reliable.