100例口腔颌面部游离组织移植的临床分析

A review of 100 consecutive free flap transfer for head and neck reconstruction

目的 对 1 0 0例口腔颌面部游离组织移植作回顾性分析。方法 分析 1 0 0例游离组织瓣的类型、受区血管、血管吻合方式和技术、皮瓣成活情况及术后并发症的发生情况 ,并分析有可能影响皮瓣成活的各种因素。结果 前臂皮瓣、腓骨瓣和腹直肌瓣为最常用的三种游离组织瓣 ,占全部皮瓣的 94 % ;皮瓣的成功率为 97% ,皮瓣血栓的发生率为 6% ,抢救成功率为 50 % ;受区和供区总的并发症发生率为 3 2 % ,但大多数并发症均不严重 ,没有造成明显的后果 ;吸烟、饮酒、放疗和年龄 (高龄和儿童 )等均非影响游离组织瓣移植成功的重要因素。结论 口腔颌面部游离组织移植安全可靠 ,其明显优于传统的带蒂组织移植 ,值得进一步推广和普及。

Objective To review 100 consecutive free tissue transfers for head and neck reconstruction in a new microsurgery unit.Methods One hundred consecutive free tissue transfers performed in 96 patients from May 26,1999 to June 8,2000 were reviewed.Data concerning the operation included date of surgery,defect description and site,stage,flap type,recipient vessel and type of anastomosis used and complications.Results The free radial forearm flap was most commonly used,followed by free fibula flap,rectus abdominis flap,illiac crest flap,scapular flap,and latissumus dorsi flap.The overall success rate was 97%.The overall complication rate was 32%.The vessel thrombosis rate was 6 percent,and the flap salvage rate was 50 percent.Conclusion Free tissue fransfer in oral and maxillofacial region is safe and reliable.It is superior to the conventional pedicaled flap technique.