口腔颌面肿瘤术后骨与软组织修复重建的临床研究

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1、中图分类号：R782.2+3；R782.2+4；R782.2+5；R782.2+6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„„„11.1中文摘要„„„„„„„„„„„„„„„„„„„„„11.2英文摘要„„„„„„„„„„„„„„„„„„„„„21.3前言„„„„„„„„„„„„„„„„„„„„„„„41.4临床资料„„„„„„„„„„„„„„„„„„„„„51.5结果„„„„„„„„„„„

2、„„„„„„„„„„„„61.6讨论„„„„„„„„„„„„„„„„„„„„„„„121.7结论„„„„„„„„„„„„„„„„„„„„„„„211.8参考文献„„„„„„„„„„„„„„„„„„„„„221.9中英文名词对照表„„„„„„„„„„„„„„„„„242致谢„„„„„„„„„„„„„„„„„„„„„„„253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

3、～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SPSS17.0统计软件进行数据分析。结果：组织瓣共131块，总成功率达95.41％。其中胸大肌皮瓣是最常用的组织瓣占（28.89％），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

4、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1TumorsinducedcraniofacialdefectsinrepairandreconstructionofclinicalresearchAbstract

5、PURPOSE:Explorethevalueofthedifferenttissueflapinoralandmaxillofacialtumordefectandrepair,optimizerepairofreconstructionprogramsandindividualreconstructionoftheadvantage.METHODS:RetrospectiveanalysisoftheSeptember2009andJanuary2012,ourhospitalOralandMaxillofacialSurgeryfortumo

6、rinducedcraniofacialdefectsintheapplicationofflap131patients,theBoneflapsincludedfibularflap,vascularizediliacflapetal.Softtissueflapsincludedpectoralismajormyocutaneousflap(PMMF),latissimusdorsimyocutaneousflap,forearmflap.Theseflapswereusedtoreconstructthedefectsofthemaxilla

7、andmandible,tongue,cheek,floorofmouthetal.Analyzedintermsofthedistributionofage,gender,diseasetype,defectlocation,reconstructivemethodandthesuccessrateoftissueflap.SPSS17.0wasadoptedforstatisticalanalysis.RESULTS:Ourdepartmentinthepastthreeyears,totaluseoftissueflaps131thetota

8、lsuccessrateof95.41%.Thepectoralismyocutaneousflapwasthemostc