中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
6期
486-489
,共4页
刘杰%张彬%李德志%倪松%安常明%徐震纲%刘绍严
劉傑%張彬%李德誌%倪鬆%安常明%徐震綱%劉紹嚴
류걸%장빈%리덕지%예송%안상명%서진강%류소엄
外科皮瓣%头颈部肿瘤%癌,鳞状细胞
外科皮瓣%頭頸部腫瘤%癌,鱗狀細胞
외과피판%두경부종류%암,린상세포
Surgical flaps%Head and neck neoplasms%Carcinoma,squamous cell
目的 探讨当股前外侧皮瓣可用皮穿支血管(简称皮穿支)缺失时,应用周边穿支皮瓣作为替代方案完成修复过程.方法 2010年8月至2012年8月,8例头颈鳞状细胞癌患者在股前外侧皮瓣制备中发现皮穿支缺失或不足,尝试采用同侧阔筋膜张肌皮瓣(5例),股前内侧皮瓣(3例)进行替代.结果 全部8例替代皮瓣的制备均获得成功,无需再次选择新的供区.皮瓣制备时间50～85 min.5例阔筋膜张肌皮瓣血管蒂长度6～10 cm,血管蒂动脉外径2.5 ～3.0 mm,静脉外径2.5～3.5 mm.3例股前内侧皮瓣中,血管蒂长度10～15 cm,1例采用股直肌支为蒂,动静脉外径均为1.0 mm,另两例以旋股外侧动脉降支为蒂,动脉外径分别为3.5和3,0 mm,静脉外径均为3.5 mm.7例供区直接拉拢缝合,l例植皮.8例皮瓣全部成活,未发生供区并发症.结论 阔筋膜张肌皮瓣和股前内侧皮瓣可作为股前外侧皮瓣可用皮穿支缺失时的良好替代方案.
目的 探討噹股前外側皮瓣可用皮穿支血管(簡稱皮穿支)缺失時,應用週邊穿支皮瓣作為替代方案完成脩複過程.方法 2010年8月至2012年8月,8例頭頸鱗狀細胞癌患者在股前外側皮瓣製備中髮現皮穿支缺失或不足,嘗試採用同側闊觔膜張肌皮瓣(5例),股前內側皮瓣(3例)進行替代.結果 全部8例替代皮瓣的製備均穫得成功,無需再次選擇新的供區.皮瓣製備時間50～85 min.5例闊觔膜張肌皮瓣血管蒂長度6～10 cm,血管蒂動脈外徑2.5 ～3.0 mm,靜脈外徑2.5～3.5 mm.3例股前內側皮瓣中,血管蒂長度10～15 cm,1例採用股直肌支為蒂,動靜脈外徑均為1.0 mm,另兩例以鏇股外側動脈降支為蒂,動脈外徑分彆為3.5和3,0 mm,靜脈外徑均為3.5 mm.7例供區直接拉攏縫閤,l例植皮.8例皮瓣全部成活,未髮生供區併髮癥.結論 闊觔膜張肌皮瓣和股前內側皮瓣可作為股前外側皮瓣可用皮穿支缺失時的良好替代方案.
목적 탐토당고전외측피판가용피천지혈관(간칭피천지)결실시,응용주변천지피판작위체대방안완성수복과정.방법 2010년8월지2012년8월,8례두경린상세포암환자재고전외측피판제비중발현피천지결실혹불족,상시채용동측활근막장기피판(5례),고전내측피판(3례)진행체대.결과 전부8례체대피판적제비균획득성공,무수재차선택신적공구.피판제비시간50～85 min.5례활근막장기피판혈관체장도6～10 cm,혈관체동맥외경2.5 ～3.0 mm,정맥외경2.5～3.5 mm.3례고전내측피판중,혈관체장도10～15 cm,1례채용고직기지위체,동정맥외경균위1.0 mm,령량례이선고외측동맥강지위체,동맥외경분별위3.5화3,0 mm,정맥외경균위3.5 mm.7례공구직접랍롱봉합,l례식피.8례피판전부성활,미발생공구병발증.결론 활근막장기피판화고전내측피판가작위고전외측피판가용피천지결실시적량호체대방안.
Objective To explore the proposal using nearby perforator flaps as alternative reconstructive choices for anterolateral thigh (ALT) flap when lacking useful perforator.Methods From August 2010 to August 2012,8 cases with head and neck cancer were found lacking reliable perforator during ALT flap elevation,a tensor fascia latae (TFL) flap or an anteromedial thigh (AMT) flap was used to complete the reconstruction.Results All 8 alternative flaps were successfully harvested,other donor sites were not needed.Flap harvest time was 50-85 min.Of 5 TFL flaps,pedicle lengths were 6-10 cm,and the diameters of the arteries and veins were 2.5-3.0 mm and 2.5-3.5 mm respectively.Of 3 AMT flaps,pedicle lengths were 10-15 cm,the rectus femoris branch was used as pedicle in 1 flap,with artery and vein more than 1.0 mm in diameter,and the descending branch of the lateral circumflex femoral artery was used as pedicle in other 2 flaps,the diameters of the arteries were 3.5 and 3.0 mm respectively,the diameters of the veins were 3.5 mm.The donor sites were directly closed in 7 cases and skin graft was performed in another case.All the flaps were alive and no complication was found in the donor sites.Conclusion TFL or AMT flap is an good alternative to ALT flap lacking useful perforator.
