CAJ | 학술논문

目的：??探讨游离股前外侧肌皮瓣在口腔颌面部修复重建的价值。方法??收集2002年2月—2013年6月间在中南大学湘雅二医院口腔颌面外科住院，进行了股前外侧肌皮瓣修复的患者1?185例（1?212块皮瓣）。记录并统计患者的基本资料、缺损部位、皮瓣的面积及类型、受区血管的处理方法、供区并发症、患者术后生存质量等情况。结果??1?212块皮瓣成活1?176块，坏死36块，成活率97.0%。皮瓣供区无严重并发症出现。股前外侧肌皮瓣重建口腔颌面部各个部位的缺损后，90%以上的患者得到了良好的功能恢复及美观效果。吻合1根静脉与吻合2根静脉相比，可以显著地缩短显微操作时间（P=0.0003）。2组的静脉危象发生率、抢救成功率及静脉危象导致的皮瓣坏死率均无统计学差异（P>0.05）。结论??股前外侧肌皮瓣组织供应量大，可满足口腔颌面部各个部位缺损的修复要求。股前外侧肌皮瓣比其他游离皮瓣，更适合用于口腔颌面部缺损修复，应作为首选皮瓣。
목적：??탐토유리고전외측기피판재구강합면부수복중건적개치。방법??수집2002년2월—2013년6월간재중남대학상아이의원구강합면외과주원，진행료고전외측기피판수복적환자1?185례（1?212괴피판）。기록병통계환자적기본자료、결손부위、피판적면적급류형、수구혈관적처리방법、공구병발증、환자술후생존질량등정황。결과??1?212괴피판성활1?176괴，배사36괴，성활솔97.0%。피판공구무엄중병발증출현。고전외측기피판중건구강합면부각개부위적결손후，90%이상적환자득도료량호적공능회복급미관효과。문합1근정맥여문합2근정맥상비，가이현저지축단현미조작시간（P=0.0003）。2조적정맥위상발생솔、창구성공솔급정맥위상도치적피판배사솔균무통계학차이（P>0.05）。결론??고전외측기피판조직공응량대，가만족구강합면부각개부위결손적수복요구。고전외측기피판비기타유리피판，경괄합용우구강합면부결손수복，응작위수선피판。
Objective??To?examine?the?benefits?of?anterolateral?thigh?myocutaneous?flaps?in?reconstruction?of?oral?and?maxillofacial?defects. Methods??Patients?were?recruited?from?February?2002?to?June?2013?in?the?Department?of?Oral?and?Maxillofacial?Surgery?of?Central?South?University.?All?patients?(1?185?patients,?1?212?transferred?flaps)?underwent?reconstruc-tive?surgery?employing?anterolateral?thigh?myocutaneous?flaps.?Basic?information?for?all?patients?including?defect?side,?flap?size?and?type,?recipient?vessel?processing?method,?donor?complications,?and?postoperative?quality?of?life?were?recorded?and?statistically?analyzed.?Results??Among?the?1?212?transferred?flaps,?1?176?survived?and?36?showed?necrosis,?for?a?survival?rate?of?about?97.0%.?No?cases?presented?with?local?serious?complications,?and?90%?of?patients?achieved?good?functional?recovery?and?aesthetically?acceptable?results?after?reconstruction?of?oral?and?maxillofacial?defects?at?various?locations?using?anterolateral?thigh?myocutaneous?flaps.?The?time?for?anastomosis?of?one?vein?was?significantly?less?than?that?for?two?veins?(P=0.000 3), which?indicated?one?vein?anastomosis?could?significantly?reduce?the?operating?time.?The?incidence?of?venous?crisis,?the?sur-vival?rate?after?treatment,?and?the?rate?of?venous?crisis?resulting?in?flap?necrosis?were?comparable?between?the?groups?(P>0.05).?Conclusion??Anterolateral?thigh?myocutaneous?flaps?can?be?easily?obtained?and?provide?a?good?amount?of?muscle?for?filling?dead?space?and?fascia?lata.?These?flaps?can?meet?the?various?requirements?of?oral?and?maxillofacial?defects.?Therefore,?the?anterolateral?thigh?myocutaneous?free?flaps?are?more?suitable?for?oral?and?maxillofacial?defects?than?other?flaps.