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目的 :通过对股前外侧穿支皮瓣的解剖学研究,探讨制备股前外侧穿支皮瓣的合理性及稳定性;并对临床上应用股前外侧穿支皮瓣的供区及受区的术后恢复情况等进行随访,评价其在口腔颌面部缺损修复重建中的应用价值。方法:选取6例中国成人下肢标本,解剖并记录股前外侧穿支的数目、分布、部分层面血管外径及各段血管长度;并选择9例采用股前外侧穿支皮瓣移植修复口腔颌面部缺损的病例,皮瓣面积5 cm×6 cm~6 cm×12 cm。术后随访观测皮瓣存活情况,评价受区臃肿度及供区功能恢复、术后吞咽及语言功能情况。结果:6例下肢标本共测量记录到股前外侧穿支21支,平均3.5支。大腿股前外侧穿支主要出现在髂前上棘至髌骨外侧缘连线中点外1 cm以下约2 cm为圆心、半径约6 cm的圆内,源动脉起始部外径平均为(2.99±0.48)mm,血管蒂总长度平均为(15.83±3.52)cm;9例股前外侧穿支皮瓣,1例发生部分组织坏死,1例病例失访,术后随访10~47个月(平均24个月)。股前外侧穿支皮瓣存活率较高,供区并发症少,受区皮瓣臃肿程度低,吞咽功能恢复良好。结论:股前外侧穿支皮瓣穿支分布稳定,血管蒂较长,穿支的管径完全满足游离皮瓣的要求,临床应用中供区并发症少,受区不臃肿,组织量适中,结合其解剖稳定性,可满足临床修复口腔颌面部组织缺损的需要。
OBJECTIVE: To investigate the rationality and stability of preparation of anterolateral perforator flaps through anatomical study on the anterolateral femoral perforator flaps. Of the postoperative recovery were followed up to evaluate its value in the reconstruction of oral and maxillofacial defects. Methods: Six adult Chinese lower extremities were selected and the number and distribution of lateral perforators, the outer diameter of vessels and the lengths of blood vessels in each segment were dissected and recorded. Nine patients underwent anastomosed anterior flaps Cases of facial defects, flap area 5 cm × 6 cm ~ 6 cm × 12 cm. Surgical follow-up observation of flap survival, assessment of bloated area and donor area function recovery, postoperative swallowing and language function. Results: Six cases of lower extremity specimens were measured and recorded to the anterolateral perforating branches 21, an average of 3.5. The thigh anterolateral perforation occurred mainly in the anterior superior iliac spine to the midpoint of the lateral edge of the patella, about 1 cm below the center of about 2 cm, a radius of about 6 cm in the circle, the starting point of the average diameter of the origin artery (2.99 ± 0.48) mm, and the total length of pedunculated pedicle was (15.83 ± 3.52) cm. There were 9 cases of anterolateral perforator flap, 1 case had partial tissue necrosis, 1 case was lost to follow-up, and 10 to 47 months Average 24 months). Pre-anterolateral perforator flap survival rate higher for the district less complications, by the district flap bloat low, swallowing function recovered well. Conclusions: The perforating branches of the lateral perforating branch of the anterolateral femur are stable in distribution and longer in the vascular pedicle, and the diameter of the perforator completely meets the requirements of the free flap. There are few complications for the donor area in the clinical application, not bloated area, moderate amount of tissue, Combined with its anatomical stability, to meet the needs of clinical repair of oral and maxillofacial tissue defects.