唇颊部洞穿性缺损综合外科修复.doc

唇颊部洞穿性缺损综合外科修复[摘要]目的:探讨修复复杂毁损性面颊部洞穿性缺损的方法,分析唇颊部洞穿性缺损修复的特点。方法:采用个体化治疗方案,以组织移植为基本方法,综合应用多项整形外科技术以及颅颌面外科技术,对10例唇颊部洞穿性缺损进行分期序列治疗。治疗周期最短半年,最长4年。 结果:随访半年至3年,面部毁损性容貌明显改善,面部轮廓形态接近正常,功能恢复良好,患者满意度较高。结论:唇颊部洞穿性缺损治疗难度大,技术要求高,在熟练掌握整形外科基本技能的前提下,结合多项整形外科基本技术,分期序列进行修复,可以获得比较满意的效果。 [关键词]洞穿性缺损;唇颊部;外科修复 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)06-0799-03 Comprehensive application of plastic surgery technique to repair full-thickness l ip-cheek defects JIN Xiao-lei,TENG Li,XU Jia-jie,LU Jian-jian,ZHANG Chao,ZHANG Bo,GUI Lai (The Fifth Department of Plastic Surgery,Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Sciences,Beijing 100144, China) Abstract:ObjectiveTo explore the effective way of repairingseriously devastated and full-thickness lip-cheek defects, and analyze the characteristics of repairing this kind of defects.MethodsOn the foundation of tissue transplantation,individualized therapeutic strategy was used,together with integrated application of basic technique of plastic surgery and craniofacial surgery. Ten cases with full-thickness lip-cheek defects were treated systematicallyby stages. The therapeutic period is between six months and 4 years. ResultsAfter sixmonths to three years follow-up,the devastated facial appearances have improved significantly. Meanwhile,facial contours were close to normal. The function of lip-cheek region recovered well with high satisfaction.ConclusionThough it is difficult to repair full-thickness lip-cheek defect due to the high technical demands,on the basis of the skilled application of plastic surgery technique,the defects can be repaired systematicallyby stages together with high satisfaction. Key words: full-thicknessdefects;lip-cheek region;surgical repair 各种原因如外伤、电击伤、肿瘤切除、特殊感染等引起的严重唇颊部洞穿性缺损,不仅严重影响患者容貌,而且影响其进食、咀嚼、发音等多项功能。由于涉及到颌面部皮肤、软组织、口腔粘膜甚至上下颌骨的缺损,修复较困难,如何能够获得满意的形态功能恢复,一直是整形外科医师面临的巨大挑战。1998年1月～2008年8月,笔者针对不同病例缺损的具体特点,综合应用多种整形外科原则和技术,共修复10例唇颊部洞穿性缺损,取得了较满意效果。 1资料和方法 1.1一般资