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目的·探讨旋髂浅动脉穿支(SCIP)皮瓣的影像学、解剖学及其在口腔癌术后修复中的临床应用。方法·采用SCIP皮瓣修复15例口腔癌根治术后缺损。所有患者术前均进行CT血管造影、彩色多普勒超声和/或磁共振血管造影检査。术中进行穿支皮瓣的血管解剖,受区缺损重建,对术后受、供区功能恢复进行评价。术后随访2~10个月。结果·切取的SCIP皮瓣平均面积为(46±22)cm~2,平均厚度为(1.2±0.3)cm;旋髂浅动脉与旋髂深动脉和腹壁浅动脉的关系可以分为5型:Ⅰ型(8/15),Ⅱ型(2/15),Ⅲ型(2/15),Ⅳ型(2/15),Ⅴ型(1/15)。患者术后受区外形丰满,张口度、语音和咀嚼功能恢复良好。结论·SCIP皮瓣质地柔软,穿支血管蒂较长,供区瘢痕隐蔽,是修复口腔癌缺损的良好选择。
Objective · To investigate the imaging and anatomy of the superficial iliac artery perforating branch (SCIP) flap and its clinical application in the postoperative repair of oral cancer. Methods · SCIP skin flap for the repair of 15 cases of oral cancer after radical surgery. All patients underwent CT angiography, color Doppler ultrasound and / or magnetic resonance angiography before surgery. Intraoperative perforating flap vascular anatomy, reconstruction of the defect area, postoperative, for functional recovery assessment. The patients were followed up for 2 to 10 months. Results The average area of SCIP flap was (46 ± 22) cm ~ 2 and the average thickness was (1.2 ± 0.3) cm. The relationship between superficial iliac artery and deep iliac artery and superficial abdominal artery could be divided into 5 types: Type Ⅰ (8/15), Type Ⅱ (2/15), Type Ⅲ (2/15), Type Ⅳ (2/15), Type Ⅴ (1/15). Patients in the area by the shape of fullness, mouth opening, voice and chewing function recovered well. Conclusion · SCIP flap soft texture, perforating pedicle longer, hidden scar for the area, is a good choice for the repair of oral cancer defects.