60例游离股前外侧皮瓣术后供区功能恢复及并发症的研究

Study of the complications and functional assessment of 60 free anterolateral myocutaneous flaps donor-site

目的:评估游离股前外侧肌皮瓣修复口腔颌面部缺损,术后皮瓣供区并发症及功能恢复情况。方法:通过评估表测量加问卷调查的方式描述性分析60例患者术后供区功能恢复情况及相关并发症。结果:远期并发症中患侧股四头肌肌力减弱者7例,皮肤感觉异常者50例。其中供区外上份感觉减退者10例,外中份感觉减退者39例,感觉消失者1例;外下份感觉减退者40例,感觉消失者5例;出现供区寒冷耐受不良者2例。患者认为疤痕严重影响外观者3例。结论:1术后供区的感觉障碍分布于股前外侧区,主要集中在股前外侧的中下区,其主要原因与损伤股外侧皮神经有关;2皮瓣的面积越大,皮瓣位置越靠近股外侧上份,供区出现感觉障碍的概率越大;3股前外侧肌皮瓣的肌瓣大小对术后肌力影响较小。

Objective： To investigate the complications and functional assessment of donor-site for free anterolateral myocutaneous flaps applicated in the reconstruction of oral-maxillofacial defects. In order to find a better method to redue the complications in donor-site. Method： analysing the complications and functional assessment through evaluation sheet and questionnairs. Result： The long term complications in cluded muscle weakness （n=7）, sensory disturbance （n=50）, in an- terolateral thigh upper region Sensory hypoesthesia （n=10）, in anterolateral thigh middle region sensory hypoesthesia （n=39） and sensory deprivation （n=l）, in anterolateral thigh lower region sensory hypoesthesia （n=40） and sensory deprivation （n=5）. Two patients had intolerance of cold. Conclusion： （1）.Sensory disturbance occurred in anterolateral thigh region especially concentrated in middle and lower area.It was related to the damage of lateral femoral cutaneous nerve. （2）. The risk of sen- sory disturbance was highly related of big size and higher position. 3. Muscle weakness were not significantly related to sac- rifice of the size of vastus lateralis muscle.