CAJ | 학술논문

目的探讨外伤或手术切除病变部位等原因所导致的颌面部软组织缺损患者采取邻位皮瓣技术进行修复的临床应用价值。方法抽取2008年1月至2011年12月来我院进行诊治的因外伤或手术切除病变部位所导致颌面部产生缺损的患者30例，根据其损伤的具体部位和程度，分别采用了颌面及颈部的局部推进皮瓣、鼻唇沟皮瓣等邻位带蒂皮瓣技术进行即刻修复，对其临床资料及其效果进行回顾性总结分析。结果术后30例患者的皮瓣全部成活，其中，1例患者的皮瓣区有轻度感染症状Ⅱ期愈合，29例患者Ⅰ期愈合；对所有患者进行随访观察其面部形态及功能至少六个月发现，其中1例患者的患侧口角呈轻度歪斜并张口轻度受限；肿瘤患者无复发；所有患者的皮瓣在色泽、质地、轮廓等方面与周围皮肤组织较为匹配，切口部位瘢痕组织平软；面部形态满意度100%，面部功能满意度96.67%。结论对于外伤或手术切除病变部位等原因所导致颌面部软组织缺损的患者，在坚持修复时宁近勿远，就近取材原则的基础上，采取邻位皮瓣技术进行即刻修复，不仅手术操作简便、易于掌握，而且因邻位皮瓣移位方便、血供较好，皮瓣易成活，术后患者的面部形态及功能均能达到满意的效果，值得临床推广应用。
목적탐토외상혹수술절제병변부위등원인소도치적합면부연조직결손환자채취린위피판기술진행수복적림상응용개치。방법추취2008년1월지2011년12월래아원진행진치적인외상혹수술절제병변부위소도치합면부산생결손적환자30례，근거기손상적구체부위화정도，분별채용료합면급경부적국부추진피판、비진구피판등린위대체피판기술진행즉각수복，대기림상자료급기효과진행회고성총결분석。결과술후30례환자적피판전부성활，기중，1례환자적피판구유경도감염증상Ⅱ기유합，29례환자Ⅰ기유합；대소유환자진행수방관찰기면부형태급공능지소륙개월발현，기중1례환자적환측구각정경도왜사병장구경도수한；종류환자무복발；소유환자적피판재색택、질지、륜곽등방면여주위피부조직교위필배，절구부위반흔조직평연；면부형태만의도100%，면부공능만의도96.67%。결론대우외상혹수술절제병변부위등원인소도치합면부연조직결손적환자，재견지수복시저근물원，취근취재원칙적기출상，채취린위피판기술진행즉각수복，불부수술조작간편、역우장악，이차인린위피판이위방편、혈공교호，피판역성활，술후환자적면부형태급공능균능체도만의적효과，치득림상추엄응용。
Objective To investigate the clinical value of ortho position flaps repair that the patients with maxillofacial soft tissue defects caused by trauma or surgical removal of the lesion had taken.Methods The clinical data of the patients with maxillofacial soft tissue defects caused by trauma or surgical removal of the lesio were analyzed retrospectively,all patients came to our hospital for treatment from January 2008 to December 2011,and according to the location and extent of injury,they were assigned to receive immediate restoration of the ortho position pedicle flap technology including maxillofacial and neck local advancement flaps,nasolabial flaps.Results All flaps of 30 patients survived after surgery:one case with the flaps area mild infection symptoms,II healing, and 29 patients with stage I healing;After at least six months of follow-up observation of facial morphology and function,it is found that:1 patient’s affected side numbness of the mouth was slightly askew and mouth slightly limited;cancer patients without recurrence;The flaps of all patients more matched with the surrounding skin tissue in terms of color, texture, contour, and incision scar tissue was soft;100%of facial morphology satisfaction,96.67%of the facial features satisfaction.Conclusion To the patients with maxillofacial soft tissue defects caused by trauma or surgical removal of the lesion,according to the principle of the nearest drawn ,taking ortho position flaps repair is worthy of clinical application,it has many advantages such as easy operating, easy mastering,the flaps convenient easy to survive,better blood supply,satisfactory facial morphology and function recovery,etc.