应用股前外侧游离组织瓣修复头颈部肿瘤术后缺损临床分析

Clinical analysis of microsurgical anterolateral thigh free flap for head and neck region reconstruction

目的:总结应用股前外侧游离组织瓣修复头颈部肿瘤术后缺损成功的经验。方法:行股前外侧游离组织瓣修复头颈部肿瘤术后缺损179例,术后观察皮瓣成活率和并发症。结果:股前外侧皮瓣成活177例(98.9%),失败2例;14例(7.8%,14/179)患者出现术后早期局部并发症;8例(4.4%,8/179)术后发生皮瓣危象,二次手术探查抢救成功6例,直接切除皮瓣2例,行胸大肌皮瓣修复。结论:术中血管吻合通畅、止血彻底和术后6h内密切观察皮瓣情况,是提高股前外侧游离皮瓣修复头颈部肿瘤术后缺损成功率的关键。

Objective：To summarize the experience of improving survival rate of microsurgical free flap transfers for head and neck reconstruction.Method：One hundred and seventy-nine consecutive microsurgical free flap transfers performed in patients with head and neck region defects after surgical procedure due to carcinoma were reviewed.The microsurgical free flap survival rate and postoperative complication were evaluated.Result：The overall success rate of flap was 98.9%.The overall complication rate was 7.8%.The flap crisis rate was postoperative flap crisis incidence rate was 4.4%.The success rate of immediate surgical exploration within 6hours successfully rescued the flap in were 6six cases,and the other else two cases cut died flap and repaired the region defect in the head and neck with pectoralis major myocutaneous flap.Conclusion：Key factors in improving the succeess rate are to guarantee vascular anastomosis patency,to achieve a good haemostasis,and to promptlyclosely observe discover blood vesselflap crisis after operation in the first 6hours and immediate surgical exploration.