局部皮瓣在唇缺损修复中的应用(1)
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[摘要]目的：探讨局部皮瓣在唇缺损修复中的应用及效果。方法：本组共31例各种原因所致唇缺损病例，根据缺损的程度及部位，分别应用不同的局部皮瓣进行修复。唇缺损范围≤1/3唇长，行直接拉拢缝合并Z改形术；唇缺损范围1/3～1/2，应用唇复合组织瓣或对侧唇交叉瓣修复；下唇缺损范围1/2～2/3，应用同侧唇颊部旋转皮瓣修复。结果：所有病例皮瓣全部成活，唇部外观明显改善，效果满意。2例下唇缺损范围1/2～2/3者修复后患侧红唇组织厚度不足，其余病例上下唇比例基本协调，局部组织无明显畸形，术后功能良好。随访2月～4年，唇部外观无明显变形及功能障碍，无复发及死亡病例。结论：对于唇缺损的修复，应根据缺损的程度及部位等具体情况选择正确的局部皮瓣以利于恢复唇部的良好形态及功能。
[关键词]唇缺损；局部皮瓣；修复
[中图分类号]R622[文献标识码]A[文章编号]1008-6455(2011)03-0365-03
Clinical application of local flap in reconstructing lip defect
WANG Qi-ying,WANG Xi-mei,LIU Lin-bo
( Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)
Abstract:ObjectiveTo explore the clinical methodology and effects of local flap in reconstructing lip defect.Methods31 cases suffering lip defect were treated differently according to degree, size and location of defects. Direct suture combined Z plasty were used in reconstructing less than one-third lip defect, and lip compound flaps or cross-lip flaps were used to repair lip defect ranged one-third to half , and unilateral labial-buccal rotating flaps were used to repair lip defect ranged half to two-thirds.ResultsAll flaps were survived well. 2 cases of lip defect ranged half to two-thirds gained thin thickness, while 29 cases were repaired with an ideal appearance as well as good functional results. The follow-up results for 2 months to 4 yearspost-operation showed satisfactory results without death and leisions recurrence.ConclusionReconstructing lip defect with the local flap should be based on the degree, size, location and individual conditions of defect. Choose the best local flap would raise therapeutic efficacy,lessen complications and gained a satisfactory lip appearance and function.
Key words: lip defect;local flap;reconstruction
唇部是面部重要的美学区域之一，唇部可因创伤、肿瘤、痣等病变切除造成不同程度的缺损畸形及功能障碍。由于唇部特殊的解剖结构，对于唇缺损修复方式的选择至关重要。我科自2006年7月～2010年7月应用局部皮瓣修复不同原因所致唇缺损，效果满意，报道如下。
1临床资料
本组病例31例，男18例，女13例，年龄2～72岁。唇缺损原因：外伤16例，其中车祸伤3例，人、犬咬伤13例；唇部肿瘤切除11例，其中血管瘤3例，基底细胞癌3例，鳞状细胞癌5例，恶性肿瘤病例未发现区域淋巴结肿大；唇部黑色素痣切除4例。唇缺损部位：上唇18例，下唇13例，均为单侧唇组织缺损，主要为唇红组织缺损。唇缺损范围：上唇缺损宽度≤1/3唇长12例，1/3～1/2者6例；下唇缺损宽度≤1/3唇长4例，1/3～1/2者7例，1/2～2/3者2例。
2治疗方法
2.1所有病例均行手术治疗 ......
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