摘要
目的 探讨游离股前内侧穿支皮瓣在舌癌术后缺损修复与舌再造中的应用.方法 2010年9月至2015年1月应用游离股前内侧穿支皮瓣对57例舌癌患者舌、颌、颈联合根治术后同期行舌、口底缺损修复与舌再造,其中舌缘癌36例,舌腹癌15例,口底癌累及舌6例.结果 切取皮瓣面积为5.5 cm＆#215;4.0 cm-7.5 cm＆#215;5.5 cm,厚度为1.0～1.7 cm.28例穿支血管蒂来源于旋股外侧动脉降支,长度为（8.2±0.6） cm;17例来源于股深动脉,长度为（8.5±0.4） cm;12例来源于股动脉,长度为（8.1±0.7）cm.57例穿支皮瓣全部存活,供区均直接拉拢缝合.随访12～ 24个月,所有患者再造舌形态良好,舌体活动自如,吞咽和语言功能满意,肿瘤局部无复发.供区仅遗留线状瘢痕,大腿功能无明显影响.结论 游离股前内侧穿支皮瓣是修复舌癌术后口底缺损及舌再造的较好方法.
Objective To investigate the application of free anteromedial thigh （AMT） perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma.Methods From September 2010 to January 2015,57 cases with tongue carcinoma underwent radical resection,leaving tongue and mouth floor defects which were reconstructed by AMT perforator flaps at the same stage.These 57 eases included tongue carcinoma at lingual margin （n =36）,at ventral tongue （n =15） and at mouth floor （n=6）.Results The size of AMT perforator flap ranged from 5.5 cm ＆#215;4.0 cm to 7.5 cm ＆#215; 5.5 cm,the thickness of flap ranged from 1.0-1.7 cm.The length of pedicle from descending branch of lateral circumferential femoral artery is （8.2 ± 0.6） cm,found in 28 cases.The length of pedicle from profunda femoral artery is （8.5 ±0.4） cm,found in 17 cases.The length of pedicle from femoral artery is （8.1 ± 0.7） cm,found in 12 cases.All 57 perforator flaps survived uneventfully,the defects at donor site were closed directly in all cases.All patients were followed up for 12-24 months with satisfactory esthetic and functional results in reconstructed tongue.No local recurrence happened.Only linear scar left in the donor sites,the function of thighs were not affected.Conclusions The free AMT perforator flap is an ideal choice for reconstruction of the tongue and mouth floor defect after radical resection of tongue carcinoma.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2017年第2期106-111,共6页
Chinese Journal of Plastic Surgery
基金
湖南省自然科学基金面上项目（13JJ5012）
湖南省科技计划项目（2014SK3002）
湖南省卫计委课题项目（B2014-111）
关键词
穿支皮瓣
股前内侧皮瓣
游离皮瓣
舌肿瘤
Perforator flap
Anteromedial thigh flap
Free skin flap
Tongue neoplasms
