摘要
目的:对同期行自体游离髂骨修复重建下颌骨缺损患者的临床资料进行回顾性分析,比较非血管化/血管化两种髂骨移植形式修复下颌骨部分或节段性缺损术后的成活率。方法:选择2008年1月～2010年12月,在武汉大学口腔医院口腔颌面外科行同期自体游离髂骨移植修复重建下颌骨缺损的患者35例。回顾临床资料,对血管化或非血管化髂骨移植的病变类型、下颌骨缺损的部位和大小、修复重建方法以及髂骨的成活率进行比较。结果:纳入研究对象35例,男19例,女16例。年龄16～65岁,平龄39岁。非肿瘤性疾病4例,占11.6%;良性肿瘤22例,占62.7%;恶性肿瘤9例,占25.7%。血管化和非血管化髂骨的平均长度分别为(5.9±1.2)cm和(5.5±1.4)cm,(P=0.407);平均高度分别为(2.7±0.4)cm和(2.3±0.6)cm,(P<0.05)。血管化髂骨和非血管化髂骨的总成活率分别为100%和76.2%,(P<0.05)。非血管化髂骨修复重建下颌骨部分缺损和节段性缺损的成活率分为别91.7%和55.6%,(P=0.055)。非血管化髂骨长度>5.5 cm和≤5.5 cm的下颌骨缺损的成活率分别为63.6%和91.7%,(P=0.311)。结论:血管化髂骨移植适用于长度在8cm以内的下颌骨体部分或节段性缺损的修复重建;非血管化髂骨适用于修复重建长度<5.5 cm的下颌骨部分缺损。
Objective： This study is to retrospectively evaluate the clinical data of patients with mandibular defects using autogenous iliac bone graft for contemporary mandibular reconstruction,and then to compare success rate of vascularizcd/non-vascularized iliac bone grafts for the reconstruction of segmental/partial mandible defect. Method： Patients who underwent immediate mandibular reconstruction at the Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, between January 2008 and December 2010 were reviewed. The evaluated contents included gender, age,pathologic disorder, site and size of mandibular defect and success rate of iliac bone grafts. Result： Clinical data of 35 patients were collected for analysis. There were 19 male and 16 female patients. The average age was 39 years. The reasons resulting in the mandibular defect were non-tumorous diseases in 4 （11.6 %） patients, benign neoplasms in 22 （62.7 %） and malignancies in 9 （25.7 %）. The average length of vascularized and non-vaseularized iliac bone grafts was （5.9±1.2）cm and （5.5±l.4）cm,respectively （P =0.407）. The overall success rate of vascularized and non-vascularized iliac bone grafts was 100 % and 76.2 %, respectively （P 〈0.05）. The success rate of non-vascularized iliac bone grafts used for segmental and partial mandible defect was 91.7 % and 55.6 %,respectively （P =0.055）. The success rate of non- vascularized iliac bone grafts larger then 5.5 cm and less than 5.5 cm was 63.6 % and 91.7 %,respectively （P =0.311）. Conclusion： Vascularized iliac bone graft is suitable for segmental and partial defects less than 9 cm in length of body of the mandible; Non-vascularized iliac graft remains a usable choice in mandibler reconstruction of partial defects less than 5.5 cm in length.
出处
《临床口腔医学杂志》
2013年第6期351-353,共3页
Journal of Clinical Stomatology
关键词
下颌骨缺损
血管化
非血管化
髂骨移植
mandibular defect
vascularized
non-vascularized
iliac bone graft
