应用Abbe’s瓣联合上唇人中皮瓣修复双侧唇裂术后继发畸形.docVIP

应用Abbes瓣联合上唇人中皮瓣修复双侧唇裂术后继发畸形[摘要]目的：探讨应用Abbe’s瓣联合上唇人中皮瓣修复双侧唇裂继发畸形的方法和优缺点。方法：手术分两期进行，第一期将上唇人中皮瓣向上转移以延长鼻小柱，上唇部的缺损用以一侧下唇动脉为蒂的Abbe’s瓣来修复，术后10～14天行二期断蒂手术。 结果：临床应用12例，其中男5例，女7例，唇瓣完全成活，上唇形态接近正常，鼻畸形矫正满意。结论：应用Abbe’s瓣联合上唇人中皮瓣修复双侧唇裂继发畸形可获得满意的上唇形态，但其缺点是需要两次手术及下唇供瓣区遗留切口瘢痕，并且此皮瓣易出现静脉回流问题。因此在上唇组织量足够时，叉状皮瓣法仍是双侧唇裂继发畸形较好的治疗方法。 [关键词]Abbes瓣；唇裂；继发畸形 [中图分类号]R782.2[文献标识码]A[文章编号]1008-6455（2008）08-1158-02 Repair the secondary defects of the bilateral cleft lip using the Abbe’s flap combined with the philtrum flap LI Feng-yong,LI Yang-qun,WANG Yong-qian,YANG Zhe,ZHANG Xue (The South 2nd Department of Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100041,China) Abstract:ObjectiveTo investigate the advantage and disadvantage of the Abbe’s flap combined with the philtrum flap to repair the secondary defects of the bilateral cleft lip.MethodsTwo-stage operation is performed. In the first stage, philtrum flap is transferred upward to lengthen the columella nasi, then the defect of philtrum is repaired with the Abbe’s flap which receive blood supply from inferior labial artery. In the second stage, the pedicel of Abbe’s flip is cut off 10-14 days after the first stage operation.ResultsThis operative method was performed in 12 cases, 5 males and 7 females. All the flaps survived with satisfactory outcome both in function and appearance.ConclusionTo repair the secondary defects of the bilateral cleft lip, satisfactory function and appearance of the upper lip and the nose can be gotten by using the Abbe’s flap combined with the philtrum flap. But the disadvantage of this method is needing two-stage operation and remaining the scar in the donor region. In addition, the problem of venous circumfluence of the Abbe’s flap may occur in some cases. Thus if there is sufficient tissue in the upper lip, fork flap is still the better treatment to the secondary defects of the bilateral cleft lip. Key words: Abbe’s flap; cleft lip；secondary