胸背动脉穿支扩张皮瓣游离移植修复面颈部大面积瘢痕的临床研究

Clinical study of expansion of thoracic dorsal artery perforators flap transplantation in repairing large scar in faciocervical region

目的探讨胸背动脉穿支扩张皮瓣游离移植修复面颈部大面积瘢痕的临床效果。方法选择本院2010年10月-2014年10月诊治的面颈部大面积瘢痕患者46例，采用随机数字表法分为两组，23例患者采用上臂内侧扩张皮瓣移位修复为对照组，23例患者采用胸背动脉穿支扩张皮瓣游离移植修复为观察组，比较两组患者的修复效果。结果观察组患者术后颈颏角恢复范围（87．96±11．02）°、术后颈后伸角度（41．20±5．27）°、术后颈左偏角度（44．28±1．06）°、术后颈右偏角度（44.31±1．15）°均明显大于对照组的（74．63±10．19）°、（37．46±3．98）°、（40．03±O．87）°、（40．12±0．79）°，并发症发生率（4．3％）明显低于对照组（26．1％），差异有统计学意义（P〈0．05）。结论胸背动脉穿支扩张皮瓣游离移植修复面颈部大面积瘢痕的效果较好，并发症少，易为患者接受。

Objective To explore the clinical effect of expansion of thoracic dorsal artery perforators flap transplanta- tion in repairing large scar in facioeervical region. Methods 46 patients with large scar in faciocervieal region from October 2010 to October 2014 of our hospital were selected.Patients were divided into two groups according to random number table.23 patients in control group were given shift of the upper arm medial expansion flap repair,23 patients in observation group were given expansion of thoracic dorsal artery perforators flap transplantation.Repair effects between two groups were compared. Results In observation group,the recovery of cervical chin angle range was （87.96±11.02）°, postoperative neck angle was（41.20±5.27）°,postoperative neck left angle was（44.28±1.06）° and postoperative neck fight angle was（44.31 ±1.15）°,whieh were significantly more than that were respectively（74.63±10.19）°,（37.46±3.98）°,（40.03± 0.87）° and （40.12±0.79）°in control group.The incidence rate of complications was 4.3% in observation group,significant lower than 26.1% in control group and the difference was statistics significance（P〈0.05）. Conclusion Expansion of tho： racic dorsal artery perforators flap transplantation in repairing large scar in faciocervieal region has better effect and less complications,which is easily accepted by patients.