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目的探讨几种组织瓣移植在口腔颌面肿瘤术后软组织缺损与修复中的应用价值。方法分析2006年4月至2008年12月间组织瓣移植患者34例,共制备皮瓣36块,包括胸锁乳突肌皮瓣、胸大肌皮瓣、前臂桡侧皮瓣,分别用于修复舌、腭、颊、口底、口咽及面颈部大面积复合缺损。分析各组织瓣移植的疗效。结果制备皮瓣36块中,皮瓣坏死4块。34例患者术后获随访1～3年,随访期间无1例病灶复发;7例区域复发,复发时间为术后4～12个月,均为术后淋巴结证实转移而术后又拒绝放疗、区域复发的患者。2例接受再手术治疗,4例死亡,其余患者均能经口腔进食,面部外形和功能均基本恢复正常。结论组织瓣移植是口腔颌面-头颈肿瘤手术根治的保障,更是术后缺损修复的主要手段,应根据不同适应证进行选择;采用不同组织瓣修复口腔颌面部缺损对患者术后外形及功能具有重要意义。
Objective To investigate the value of several kinds of flap transplantation in soft tissue defects and repair of oral and maxillofacial tumors. Methods From April 2006 to December 2008, 34 patients undergoing tissue flap transplantation were enrolled. A total of 36 flaps were prepared, including sternocleidomastoid flap, pectoralis major myocutaneous flap and forearm radial flap, respectively Repair of the tongue, palate, buccal, oral floor, oropharyngeal and face and neck large area composite defect. Analysis of the effect of flap transplantation. Results in the preparation of 36 flaps, flap necrosis 4. 34 patients were followed up 1 to 3 years, no recurrence of lesions during follow-up; 7 cases of regional recurrence, the recurrence time is 4 to 12 months after surgery, both postoperative lymph node metastasis confirmed and refused to postoperative radiotherapy, Regional recurrence of patients. Two patients underwent reoperation and four died. All the other patients were able to eat via the oral cavity, and their facial appearance and function returned to normal. Conclusions Tissue flap transplantation is the guarantee of surgical treatment of oral and maxillofacial-head and neck neoplasms. It is the main means of postoperative defect repair. It should be selected according to different indications. Using different tissue flaps to repair the defects of oral and maxillofacial region, Function is of great importance.