目的 探讨应用以面动脉分支为穿支的鼻唇沟皮瓣修复中面部肿瘤切除术后创面的临床效果.方法 2012年1月至2015年6月,收治中面部肿瘤患者31例,其中基底细胞癌1 8例,鳞状细胞癌13例.肿瘤大小0.8 cm ×2.0 cm～2.0 cm ×3.5 cm,根据肿瘤性质扩大切除肿瘤组织,送术中冰冻,提示边缘及基底无肿瘤侵犯后,根据创面位置、大小及血管穿支情况,设计以面动脉分支为穿支的鼻唇沟皮瓣修复创面,供区直接拉拢缝合.皮瓣面积1.5 cm ×3.0 cm ～3.0 cm×5.0 cm,蒂长1.0～2.5 cm.结果 术后31例患者皮瓣存活,其中26例未出现皮瓣血运障碍,5例术后皮瓣尖端出现青紫,积极治疗后恢复,切口愈合良好.随访6 ～ 36个月,供区瘢痕大部分隐藏于鼻唇沟皱褶中,未出现眼睑外翻、睑球分离、口角畸形等,皮瓣质地、颜色与正常皮肤相同,外观较满意.结论 面动脉分支穿支鼻唇沟皮瓣供区组织损伤小,转移灵活,术后外观好,是修复面部软组织缺损的较好方法.%Objective To evaluate the effect of nasolabial flap with Facial artery perforator for repairing defects after resection of midface tumor.Methods Between January 2012 and June 2015,31 cases with midface tumor,including base cell carcinoma(18 cases),squamous cell carcinoma(13 cases).The tumor size ranged from 0.8 cm × 2.0 cm to 2.0 cm × 3.5 cm.The extended resection of the tumor tissue was performed according to the characters of tumor.Intraoperative frozen specimen was used to make sure no invasion at margin and wound base.According to the location and size of the defect,nasolabial flap with perforator was designed to repair the defect,the defect at donor site was directly closed.The flaps size ranged from 1.5 cm × 3.0 cm to 3.0 cm × 5.0 cm,and the pedicle length was 1.0 cm to 2.5 cm.Results All the 31 flaps survived completely,including 5 cases with vascular crisis at the flap tip,which resolved after active procedure.All the patients were followed up for 6-36 months with unconspicious scar at nasolabial fold and no deformities.The flap had satisfactory appearance with good match of texture and color.Conclusions Nasolabial flap with facial artery perforator is an optimal choice for reconstruction of facial defects with good appearance and flexible transfer.
展开▼
