华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

儿童患者头颈部游离组织瓣移植的临床分析

毛驰,俞光岩,彭歆,郭传瑸,黄敏娴,张益   

  1. 北京大学口腔医院 口腔颌面外科,北京100081
  • 收稿日期:2004-12-25 修回日期:2004-12-25 出版日期:2004-12-20 发布日期:2004-12-20
  • 通讯作者: 毛 驰,Tel:13910003306
  • 作者简介:毛 驰(1966-),男,浙江人,教授,博士

Analysis of 30 Consecutive Free Flap Transplantation for Head and Neck Reconstruction in Paediatric Patients

MAO Chi,YUGuang-yan,PENGXin,GUO Chuan-bin,HUANGMin-xian,ZHANG Yi   

  1. Dept.ofOral andMaxillofacial Surgery, School ofStomatology,Peking University,Beijing100081,China
  • Received:2004-12-25 Revised:2004-12-25 Online:2004-12-20 Published:2004-12-20

摘要:

目的 探讨儿童患者头颈部游离组织瓣移植的安全性、可靠性和应用价值。方法 对同一手术小组完成的28例15岁以下儿童患者的30块头颈部游离组织瓣移植作回顾性研究。分析患者的一般情况、头颈部缺损的部位和类型、采用游离组织瓣的类型、受区血管、游离瓣成活情况及术后并发症的发生情况,并分析有可能影响游离瓣成活的各种因素。结果 28例患者一共采用了4种游离瓣,即腓骨瓣19块、前臂皮瓣5块、肩胛皮瓣和腹直肌皮瓣各3块。其游离瓣的临床成功率为93·3%(28/30),1块腓骨瓣和1块腹直肌皮瓣失败;受区和供区总的并发症发生率为36·7%,但并发症均不严重,没有造成严重的后果。结论 儿童患者头颈部游离组织瓣移植安全可靠,与成年患者相比其成功率和并发症无明显差别,值得进一步推广和应用。

关键词: 游离组织瓣移植, 显微外科, 重建, 儿童

Abstract:

Objective To analyze the reliability and feasibility of free flap transfer for head and neck reconstruction in the pae- diatric patients.Methods Thirty consecutive free flap transfer performed in 28 patients youngerthan 15 years-oldwere reviewed. Data concerningthe operation included date of surgery, defect description and site, stage and histology of tumor, flap type, recipi- ent vessel and complications.Results The average age of patientswas 12.3 years-old, with age ranged from5 to 15. Therewere 19 males and 9 females. Four kinds of free flap were used. The free fibula flap was most commonly used, followed by free radial forearm flap, rectus abdominis myocutaneous flap, and free scapular flap. The overall success rate of the flaps was 93.3%. The overall complication ratewas 36.7%. The vessel thrombosis ratewas 6.7%.Conclusion Free flap transfer in the paediatric pa- tients for head and neck reconstruction is safe and reliable. There is no difference between the normal patients and paediatric pa- tients in the success rate and complication rate.

Key words: free flap transfer, microsurgery, reconstruction, peadiatric patient