發(fā)布時間：2018-06-15 07:06

  本文選題：旋髂深動脈 + 穿支嵌合皮瓣　； 參考：《華西口腔醫(yī)學(xué)雜志》2015年03期

【摘要】：目的探討旋髂深動脈穿支嵌合髂骨皮瓣(DCIAPF)在下頜骨復(fù)合性缺損重建中的應(yīng)用價值與優(yōu)缺點。方法 2014年3—7月應(yīng)用DCIAPF游離移植一期修復(fù)6例下頜骨及軟組織復(fù)合缺損患者。根據(jù)術(shù)前定位的旋髂深動脈皮膚穿支設(shè)計并逆行切取皮島,隨后于腹股溝區(qū)順行解剖血管蒂并切取髂骨瓣,繼續(xù)解剖旋髂深血管直至終末段與皮島相續(xù)。完成DCIAPF切取后供區(qū)分層嚴密關(guān)閉以預(yù)防腹疝。結(jié)果 6例患者所制備的髂骨瓣長5.0~11.0 cm,皮島3.5 cm×5.0 cm~7.0 cm×10.0 cm,供區(qū)均一期關(guān)閉未行植皮。1例皮島穿支來自旋髂淺血管需另行吻合,其余5例成功制備為DCIAPF。移植的髂骨皮瓣均成活,僅1例因行皮島修薄處理出現(xiàn)表皮剝脫和少量邊緣壞死,經(jīng)修剪及換藥處理后愈合。術(shù)后隨訪3~6個月,牙槽嵴高度恢復(fù)滿意,供區(qū)均未出現(xiàn)明顯并發(fā)癥。結(jié)論 DCIAPF血運豐富可靠,能提供足夠的骨量供下頜骨重建并恢復(fù)牙槽嵴高度,為后期義齒修復(fù)創(chuàng)造有利條件;其皮膚穿支解剖較為恒定,攜帶皮島組織量大,擺放靈活,供區(qū)隱蔽,是下頜骨復(fù)合性缺損修復(fù)重建的有效方法。
[Abstract]:Objective to evaluate the clinical value, advantages and disadvantages of DCIAPF in reconstruction of mandibular complex defect. Methods from March to July 2014, DCIAPF free graft was used to repair 6 cases of mandibular and soft tissue composite defects. According to the skin perforating branch of deep circumflex iliac artery located before operation, the skin island was removed retrograde, then the pedicle was dissected in the inguinal region and the iliac bone flap was removed, and the deep circumflex iliac artery continued to be dissected until the end of the circumflex iliac artery continued with the skin island. After DCIAPF removal, the differentiation layer is closed closely to prevent abdominal hernia. Results the iliac bone flap of 6 patients was 5.0 ~ 11.0 cm long and the skin island was 3.5 cm 脳 5.0 cm~7.0 cm 脳 10.0 cm. The perforating branches of the iliac circumflex artery from the superficial circumflex iliac vessels were all closed in one stage. The other 5 cases were successfully prepared as DCIAPF. All the iliac flap survived, only one case had epidermis exfoliation and a little edge necrosis due to the thinning of the skin island, and healed after pruning and dressing changing. After 3 ~ 6 months follow-up, the alveolar ridge height recovered satisfactorily, and no obvious complications occurred in the donor area. Conclusion DCIAPF can provide sufficient bone mass for mandibular reconstruction and restoration of alveolar ridge height, and create favorable conditions for restoration of denture in later stage. Concealment of donor area is an effective method for reconstruction of compound mandibular defect.
【作者單位】： 中南大學(xué)湘雅醫(yī)院口腔頜面外科;
【分類號】：R782.2
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本文編號：2021150