腹壁下动脉穿支皮瓣在全舌癌缺损修复中的应用效果评价

doi:10.19438/j.cjoms.2019.06.014

中国口腔颌面外科杂志 ›› 2019, Vol. 17 ›› Issue (6): 550-553.doi: 10.19438/j.cjoms.2019.06.014

腹壁下动脉穿支皮瓣在全舌癌缺损修复中的应用效果评价

李军^1,*, 黄晶^2,*, 高炳菊¹, 邱宇¹, 林阳¹, 阮召伟³, 叶卓¹, 林李嵩¹

1.福建医科大学附属第一医院口腔颌面外科,福建医科大学面部整复与重建研究室,福建福州 350005;
2.福建医科大学转化医学研究院,福建福州 350122;
3.福建医科大学附属宁德市医院口腔科,福建宁德 352100

收稿日期:2019-03-12 出版日期:2019-11-20 发布日期:2019-12-16
通讯作者: 林李嵩,E-mail：dr-lls@163.com
作者简介:李军（1986-）,男,住院医师,E-mail：1986lijun1234@163.com;黄晶（1990-）,女,硕士,E-mail：jingjing1990@yeah.net。*并列第一作者
基金资助:
省卫生健康委医学创新课题（2017-cx-27）; 福建省教育厅中青年教师教育科研项目（JAT170215）

Application of deep inferior epigastric perforator flaps (DIEP) in total tongue reconstruction after resection of tongue carcinoma

LI Jun¹, HUANG Jing², GAO Bing-ju¹, QIU Yu¹, LIN Yang¹, RUAN Zhao-wei³, YE Zhuo¹, LIN Li-song¹

1. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Laboratory of Facial Plastic and Reconstructive Surgery. Fuzhou 350005;
2. Institute of Translational Medicine, Fujian Medical University. Fuzhou 350122;
3. Department of Stomatology, Ningde City Hospital Affiliated to Fujian Medical University. Ningde 352100, Fujian Province, China

Received:2019-03-12 Online:2019-11-20 Published:2019-12-16

摘要/Abstract

摘要： 目的: 评价游离腹壁下动脉穿支皮瓣（deep inferior epigastric perforator,DIEP）用于舌癌术后全舌缺损修复的效果。方法: 2018年1月—2018年7月应用游离DIEP修复13例舌癌患者,手术缺损部位均为全舌或近全舌缺损。术中将腹壁下动脉与甲状腺上动脉或面动脉吻合,伴行静脉与颈外静脉或颈内静脉属支吻合。结果: l3例DIEP皮瓣均修复成功,皮瓣外观满意。术后随访舌形态良好,功能满意。供区直接闭合,其中1例患者皮瓣供区出现感染,经换药后愈合。所有腹部伤口均为线性瘢痕,腹直肌功能未受明显影响,未发现腹壁疝和腹壁隆起等手术并发症。结论: 腹壁下动脉穿支皮瓣组织量丰富、血供可靠、质地柔软,再造舌外形及功能良好,且供区保留了腹直肌和前鞘,损伤小,将供区并发症降到最低限度,是舌癌术后全舌缺损修复新的可靠技术。

关键词: 全舌缺损, 腹壁下动脉穿支皮瓣, 修复与重建

Abstract: PURPOSE: To evaluate the value of deep inferior epigastric perforator flap in repairing postoperative defects after total tongue resection due to cancer. METHODS: From January 2018 to July 2018, deep inferior epigastric perforator flap was used to repair 13 total tongue defect after tongue carcinoma resection. All the deep inferior epigastric arteries were anastomosed with superior thyroid anteries or facial arteries, while the venae eomitans were anastomosed with the external jugular venae or the branches of internal jugular venae. RESULTS: Thirteen DIEP flaps survived uneventfully, the shape of the flaps in reconstruction of total tongue was satisfactory, the function was also satisfying. The donor area was closed directly. Of 13 patients, only one had abdominal wound infection, which was cured by dressing change. All abdominal wounds were healed leaving linear scar, the function of rectus abdominis was not affected obviously, and no complications such as abdominal wall hernia and abdominal wall protuberance were found. CONCLUSIONS: DIEP flap is rich in tissue, reliable in blood supply, good in shape and function. The complications of donor area are minimized. It is a new and reliable technique for reconstruction of total tongue defect.

Key words: Total tongue defect, Inferior abdominal artery perforator flap, Repair and reconstruction

中图分类号:

R782.2

李军, 黄晶, 高炳菊, 邱宇, 林阳, 阮召伟, 叶卓, 林李嵩. 腹壁下动脉穿支皮瓣在全舌癌缺损修复中的应用效果评价[J]. 中国口腔颌面外科杂志, 2019, 17(6): 550-553.

LI Jun, HUANG Jing, GAO Bing-ju, QIU Yu, LIN Yang, RUAN Zhao-wei, YE Zhuo, LIN Li-song. Application of deep inferior epigastric perforator flaps (DIEP) in total tongue reconstruction after resection of tongue carcinoma[J]. China J Oral Maxillofac Surg, 2019, 17(6): 550-553.

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腹壁下动脉穿支皮瓣在全舌癌缺损修复中的应用效果评价

Application of deep inferior epigastric perforator flaps (DIEP) in total tongue reconstruction after resection of tongue carcinoma

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