摘要
【目的】评估吻合感觉神经的股前外侧穿支皮瓣修复头颈肿瘤术后缺损的感觉重建效果。【方法】选取2013年5月至2015年5月应用吻合感觉神经的股前外侧穿支皮瓣重建头颈部肿瘤术后缺损患者35例，其中端端吻合27例，端侧吻合8例；神经外膜缝合9例，神经外膜加神经束膜吻合26例。术后4、8、16和24周监测皮瓣的感觉功能恢复情况。【结果】35例皮瓣均成活，患者面部外形恢复良好，供区伤口Ⅰ期愈合。随访1-6个月，术后4周时皮瓣痛觉、触觉及两点辨别觉等有所恢复；术后24周皮瓣感觉功能均在s2以上，已达到皮瓣的保护性感觉，感觉恢复优良率为65．7％；且皮辩的色泽、质地、弹性良好。【结论】供区股外侧皮神经具有走形规律、表浅，皮瓣设计灵活方便，手术简便易行等特点；而受区面颈部感觉神经丰富，通过吻合感觉神经的游离股前外侧穿支皮瓣修复头颈部肿瘤术后缺损，可恢复皮瓣的感觉功能，对头颈部缺损修复有重要意义。
[Objective] To evaluate the sensation restoration of neurorrhaphy of anterolateral femoral perforated skin flaps in repairing the defect after head and neck cancer resection.[Methods] Thirty-five patients underwent simultaneous sensation restoration of neurorrhaphy of anterolateral femoral perforated skin flap from May,2013 to May, 2015 were selected. Among which 27 cases were of end-to-end neurorrhaphy and 8 cases of end-to-side neu- rorrhaphy; 9 cases of epineurium neurorrhaphy, and the rest of 26 cases of epineurium neurorrhaphy plus nerve bundle neurorrhaphy. The effect on the restoration of sensation was reviewed at 4,8,16 and 24 weeks after operation respectively. [Results]All of the 35 flaps survived. Satisfying morphology for the maxillofacial region and Phase-One healing on the donor site were obtained. During the 1 to 6 months＇ follow-up, the sensation of pain, touch and two-point discrimination of the flaps were restored somewhat 4 weeks after surgery. The sensory function of flaps had reached a level above S2, which acquired the protective sensation. The excellent and good rate of sensation restoration was 65.7%. The color, texture and elasticity of skin flaps were satisfied. [Conclusion]The lateral femoral cutaneous nerve of the donor site is characterized with its regular formation which is superficial , flexible for flap designing, easy and convenient for operation etc.; on the recipient site, there is plenty of sensory nerves in maxillofacial region, and it is of great value to reconstruct the defect after resection of tumor in this region with anterolateral femoral perforated skin flaps to restore the sensation function therewith.
出处
《医学临床研究》
CAS
2016年第7期1264-1267,共4页
Journal of Clinical Research
基金
湘潭市科技计划项目（ZJ20131018）
