胸大肌肌皮瓣修复口腔颌面部缺损并发症的临床分析

An analysis of complications in oral and maxillofacial reconstruction with pectoralis major myocutaneous flap

目的 :探讨胸大肌肌皮瓣修复肿瘤术后口腔颌面部缺损发生并发症的主要因素及减少其发生的措施。方法 :对2010—2015年采用胸大肌肌皮瓣修复口腔颌面部缺损的78例患者进行回顾分析。结果 :16例患者出现与胸大肌肌皮瓣有关的并发症(20.51%),其中感染14例(17.65%),皮瓣不同程度坏死9例(11.54%),形成瘘管6例(7.69%)。结论:并发症的发生主要与患者的性别、年龄、全身状况(糖尿病、高血压)、皮瓣损伤、引流不畅有关,严格的适应证选择、精细的手术操作可有效减少并发症的发生。

PURPOSE ： To investigate the main factors and preventive measures of complications in oral and maxillofacial reconstruction after tumor resection with pectoralis major myocutaneous flaps. METHODS ： The clinical date of 78 cases with underwent pectoralis major myocutaneous flap procedures for immediate reconstruction of defects after resection of oral or maxillofacial malignant tumors from 2010 to 2015 were analyzed retrospectively. RESULTS ： Sixteen cases experienced a total of 29 complications for an overall complication rate of 20.51%. Fourteen cases had infection（17.65%） , nine had flap necrosis at different degree （11.54%）, and 6 developed fistula（7.69%）. CONCLUSIONS ： The main influencing factors of complications included sex, age, systemic diseases （diabetes, hypertension）,flap injury and inadequate drainage. Strict selection of indication and elaborate surgical manipulation can reduce the complication rate.