上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

旋髂浅动脉穿支皮瓣在口腔癌术后修复中的应用研究

何 悦1，金淑芳1，方 早1，田卓炜1，邱蔚六1，章一新2，冯少清2，陶晓峰3，周辉红4，张志愿1   

  1. 上海交通大学 医学院附属第九人民医院 1.口腔颌面-头颈肿瘤科，上海市口腔医学重点实验室，2.整复外科，3.放射科，4.超声诊断科，上海 200011
  • 出版日期:2016-08-29 发布日期:2016-08-31
  • 作者简介: 何 悦（1973—），男，主任医师，博士；电子信箱：yuehe@sjtu.edu.cn。
  • 基金资助:

    国家自然科学基金面上项目（81570949，81271112）；上海市教育委员会高原高峰学科建设计划（20152222）

Application of superficial circumflex iliac artery perforator flap in reconstruction after radical surgery of oral cancer

HE Yue1, JIN Shu-fang1, FANG Zao1, TIAN Zhuo-wei1, QIU Wei-liu1, ZHANG Yi-xin2, FENG Shao-qing2, TAO Xiao-feng3, ZHOU Hui-hong4, ZHANG Zhi-yuan1   

  1. 1. Department of Oral Maxillofacial and Head and Neck Oncology, Shanghai Key Laboratory of Stomatology, 2. Department of Plastic Surgery, 3. Department of Radiology, 4. Department of Ultrasonic Diagnosis, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

  • Online:2016-08-29 Published:2016-08-31
  • Supported by:

    National Natural Science Foundation of China, 81570949, 81271112; Shanghai Municipal Education Commission–Gaofeng Clinical Medicine Grant Support, 20152222

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摘要：

目的·探讨旋髂浅动脉穿支（SCIP）皮瓣的影像学、解剖学及其在口腔癌术后修复中的临床应用。方法·采用SCIP皮瓣修复15例口腔癌根治术后缺损。所有患者术前均进行CT血管造影、彩色多普勒超声和/或磁共振血管造影检查。术中进行穿支皮瓣的血管解剖，受区缺损重建，对术后受、供区功能恢复进行评价。术后随访2～10个月。结果·切取的SCIP皮瓣平均面积为（46±22） cm2，平均厚度为（1.2±0.3） cm；旋髂浅动脉与旋髂深动脉和腹壁浅动脉的关系可以分为5型：Ⅰ型（8/15），Ⅱ型（2/15），Ⅲ型（2/15），Ⅳ型（2/15），Ⅴ型（1/15）。患者术后受区外形丰满，张口度、语音和咀嚼功能恢复良好。结论·SCIP皮瓣质地柔软，穿支血管蒂较长，供区瘢痕隐蔽，是修复口腔癌缺损的良好选择。

关键词: 穿支皮瓣, 旋髂浅动脉, 颌面部, 癌, 缺损重建

Abstract:

Objective · To investigate the anatomic and imaging characteristics of superficial circumflex iliac artery perforator (SCIP) flap and its clinical application in reconstruction after radical surgery of oral cancer. Methods · Fifteen patients underwent the SCIP flap reconstruction after radical surgery of oral cancer. All patients received preoperative examinations with CT angiography, color Doppler ultrasonography and/or MR angiography. The vascular dissection for superficial circumflex iliac artery (SCIA) and defect reconstruction were performed intra-operatively. The function recovery in recipient and donor sites was evaluated postoperatively. Patients were followed up for 2-10 months. Results · The average area and thickness of dissected flaps were (46 ± 22) cm2 and (1.2 ± 0.3) cm, respectively. The relationship between SCIA, deep circumflex iliac artery (DCIA), and superficial inferior epigastric artery (SIEA) could be classified into type 1 (8/15), type 2 (2/15), type 3 (2/15), type 4 (2/15), and type 5 (1/15). Good aesthetic outcome was obtained after surgery in the recipient sites and mouth-open width, speech, and mastication function recovered well. Conclusion · The SCIP flap is a pliable flap with long vascular pedicles and hidden donor site morbidity and an ideal option for oral maxillofacial defect reconstruction.

Key words: perforator flap, superficial circumflex iliac artery, oral maxillofacial, carcinoma, reconstruction