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首页> 中文期刊> 《中国耳鼻咽喉颅底外科杂志》 >游离腹壁下动脉穿支皮瓣应用于舌癌术后缺损修复与舌再造

游离腹壁下动脉穿支皮瓣应用于舌癌术后缺损修复与舌再造

         
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摘要

目的 探讨游离腹壁下动脉穿支皮瓣应用在舌癌术后缺损修复与舌再造中的效果.方法 2008年12月～2016年1月应用游离腹壁下动脉穿支皮瓣对42例舌癌患者行舌癌根治术同期行舌口底缺损修复与舌再造,其中舌缘癌22例,舌腹癌17例,口底癌累及舌3例,肿瘤根治术后形成6.5 cm×3.5 cm～11.0cm×7.5 cm大小缺损.术中将腹壁下动脉与甲状腺上动脉吻合,伴行静脉与甲状腺上静脉或颈内静脉吻合.结果 皮瓣长(8.6±0.3)cm、宽(5.1 ±0.2)cm、厚(2.3±0.5)cm.腹壁下动脉穿支皮瓣血管蒂长度为(9.6 ±0.4)cm.42例肌皮瓣全部存活,供区直接闭合.皮瓣外观满意,供区仅遗留线性瘢痕,腹直肌功能未见明显影响.随访14 ～64个月.再造舌形态良好,吞咽、语言功能满意,肿瘤局部无复发.结论 腹壁下动脉穿支皮瓣组织量丰富,质地好,再造舌外形及功能良好,供区损伤小,是舌癌术后舌、口底缺损修复与舌再造的理想选择.%Objective To investigate the application of free deep inferior epigastric artery perforator flap in the repair of tongue defect and tongue reconstruction after radical resection of tongue carcinoma.Methods From Dec 2008 to Jan 2016,42 cases with tongue carcinoma underwent radical resection.Their tongues were reconstructed and the defects were simultaneously repaired with free deep inferior epigastric artery perforator flap.The primary sites of carcinomas were located at lingual margin (n =22),ventral tongue (n =17) and mouth floor (n =3).The defect sizes after resection ranged from 6.5 cm × 3.5 cm to 11.0 cm × 7.5 cm.All the deep inferior epigastric arteries were anastomosed with superior thyroid arteries,while the venae comitans were anastomosed with superior thyroid venae or internal jugular venae.Results The length,width and thickness of the flaps were (8.6 ±0.3) cm,(5.1 ±0.2) cm,and (2.3 ±0.5) cm respectively.The length of vascular pedicle was (9.6 ± 0.4) cm.All flaps survived uneventfully,the donor sites got closed directly in all cases.The appearance of flaps was satisfying,only linear scar was left in the donor sites,and the function of rectus abdominis was not affected.All patients were followed up for 12 to 24 months with satisfied esthetic and functional outcomes in reconstructed tongue.No local recurrence happened.Conclusion With advantages of abundant tissue volume to reconstruct the defects of tongue and mouth floor,good texture,good appearance and function of the reconstructed tongue and minimal morbidity at donor site,the free deep inferior epigastric artery perforator flap is a good choice for tongue defect reconstruction after resection of tongue carcinoma.

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  • 来源
    《中国耳鼻咽喉颅底外科杂志》 |2017年第5期|439-443|共5页
  • 作者

    彭小伟; 柳泽洋; 李赞; 宋达疆; 周晓; 周波; 吕春柳; 彭文; 李慧; 毛煌兴;

  • 作者单位

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

    湖南省肿瘤医院中南大学湘雅医学院附属肿瘤医院肿瘤整形头颈外科,湖南长沙410013;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类 舌肿瘤、舌下肿瘤;
  • 关键词

    腹壁下动脉穿支皮瓣; 游离皮瓣移植; 舌肿瘤; 舌再造;

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