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硕士学位论文

口腔颌面肿瘤术后骨与软组织修复重建的临床研究

院(系)、所口腔医学院
研究生姓名吴双江
学科、专业口腔临床医学
导师姓名夏德林副教授

二Ο一二年四月
目录

1 口腔颌面肿瘤术后骨与软组织修复重建的临床研究„„„ 1
中文摘要„„„„„„„„„„„„„„„„„„„„„ 1
英文摘要„„„„„„„„„„„„„„„„„„„„„ 2
前言„„„„„„„„„„„„„„„„„„„„„„„ 4
临床资料„„„„„„„„„„„„„„„„„„„„„ 5
结果„„„„„„„„„„„„„„„„„„„„„„„ 6
讨论„„„„„„„„„„„„„„„„„„„„„„„ 12
结论„„„„„„„„„„„„„„„„„„„„„„„ 21
参考文献„„„„„„„„„„„„„„„„„„„„„ 22
中英文名词对照表„„„„„„„„„„„„„„„„„ 24
2 致谢„„„„„„„„„„„„„„„„„„„„„„„ 25
3 口腔颌面肿瘤术后骨与软组织缺损修复现状(综述)„„ 27
口腔颌面肿瘤术后骨与软组织修复重建的临床研究
摘要
目的:探讨不同组织瓣在口腔颌面不肿瘤缺损与修复中的应用价值,
优化修复重建方案及个体化修复重建的优势。
方法:回顾分析 2009 年 9 月~2012 年 1 月期间,我院口腔颌面外科
所行因为肿瘤致颅颌面缺损应用组织瓣修复的患者 131 例,其骨瓣包括:
腓骨肌皮瓣、髂骨肌皮瓣等;软组织瓣包括胸大肌瓣、背阔肌瓣、前臂皮
瓣等。分别用于修复颌骨、舌、颊、口底等。对其年龄、性别、病种、缺
损部位和修复类型的分布情况,以及组织瓣的成活情况进行分类统计。采
用统计软件进行数据分析。
结果:组织瓣共 131 块,总成功率达 %。其中胸大肌皮瓣是最
常用的组织瓣占(%),胸大肌皮瓣和背阔肌皮瓣在修复大面积缺损
时常被采用,各种骨肌(皮)瓣成为我科在因肿瘤导致颅颌面缺损进行个
体化修复重建的重要手段。
结论:组织瓣移植是口腔颌面肿瘤手术根治的保障,也是术后缺损修
复的主要手段。前臂皮瓣是修复舌、颊、腭等软组织缺损的首选瓣;胸大
肌与背阔肌(皮)瓣适合修复体积较大的缺损;腓骨、髂骨肌瓣是上、下颔
骨缺损最常用的修复手段。其他不常用的组织瓣,应根据不同适应证进行
选择。采用个体化修复口腔颌面部缺损,对患者术后外形以及功能具有重
要意义。
关键词:组织瓣;修复重建;口腔颌面部;缺损;个体化修复

1
Tumors induced craniofacial defects in repair and reconstruction of
clinical research

Abstract
PURPOSE: Explore the value of the different tissue flap in oral and
maxillofacial tumor defect and repair, optimize repair of reconstruction
programs and individual reconstruction of the advantage. METHODS:
Retrospective analysis of the September 2009 and January 2012, our hospital
Oral and Maxillofacial Surgery for tumor induced craniofacial defects in the
application of flap 131 patients, the Bone flaps included fibular flap,
vascularized iliac flap et al. Soft tissue flaps included pectoralis major
myocutaneous flap(PMMF), latissimus dorsi myocutaneous flap, forearm flap.
These flaps were used to reconstruct the defects of the maxilla and mandible,
tongue, chee