眶区组织缺损修复中眶周血的应用

doi:10.6040/j.issn.1673-3770.0.2017.233

摘要/Abstract

摘要： 目的探讨眶周血供在眶区组织缺损修复中的应用。方法选取2013年12月至2016年12月确诊治疗的眶区组织缺损患者100例,依据治疗方法分为A组和B组,每组50例,A组给予耳前反流轴型皮瓣、额部岛状皮瓣、耳后反流轴型皮瓣、鼻唇沟皮瓣等眶周皮瓣旋转修复术治疗;B组在此基础上行皮下蒂皮瓣处理。结果 B组治疗优良率明显高于A组,B组愈合时间、并发症发生率低于A组,差异有统计学意义(P<0.05);两组术后血流速度(BFV)、血流灌注量相对值(BPR)水平均高于术前,B组术后BFV、BPR水平高于A组,差异有统计学意义(P<0.05)。结论眶周皮瓣血供丰富、可塑性好、色泽质地与受区相近,适用于眶区组织缺损修复,且联合皮下蒂皮瓣处理时,具有更为良好的疗效及安全性。

关键词: 血供, 组织缺损, 眶区, 修复, 眶周

Abstract: Objective The aim of this study was to investigate the application of periorbital blood supply for repairing tissue defects in the regiones orbitalis. Methods A total of 100 patients with tissue defects in the regiones orbitalis were enrolled from December 2013 to December 2016 in the hospital. According to the treatment protocol, the patients were divided into group A and group B, with 50 patients in each group. Group A was treated with periorbital flap and rotation prosthesis, such as ear before reflux axial flap, forehead island flap, and reflux after ear type axial flap, and nasolabial sulcus flap. Group B was administered subcutaneous flap treatment. Results Treatment efficiency was significantly higher in group B than in group A, but the healing time and complication rate were significantly lower in group B than in group A(P<0.05). The postoperative blood flow velocity(BFV)and blood flow rate(BPR)were significantly higher than the preoperative values. In both group A and group B, and the postoperative BFV and BPR were significantly higher in group B than in group A(P<0.05). Conclusion The periorbital flap has advantageous characteristics, such as rich blood supply, good plasticity, and similarity of materials and colors to those of surrounding regions. Therefore, the periorbital flap is suitable for repairing tissue defects in in the regiones orbitalis, and combined treatment with hypodermic and periorbital flap shows a better therapeutic effect with improved safety.

Key words: Blood supply, Repair, Periorbital flap, Regiones orbitalis, Tissue defects

中图分类号:

R779.1

李桂芬,易丽娜. 眶区组织缺损修复中眶周血的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 80-83.

LI Guifen, YI Lina. Application of periorbital blood supply for repairing tissue defects in the orbital region[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 80-83.

参考文献

[1] 吴昆旻,李泽卿,陈伟,等. 3D技术在修复鼻窦恶性肿瘤手术眶壁缺损中的应用[J]. 山东大学耳鼻喉眼学报,2017,31(1):80-84. WU Kunmin, LI Zeqing, CHEN Wei, et al. Application of three-dimensional technology in the reconstruction of orbital wall defects in malignant tumors of maxillary sinus[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(1):80-84.
[2] 郑茜匀,严宇清,殷国前,等. 转移皮瓣修复眼眶组织巨大缺损[J]. 国际眼科杂志,2013,13(5):1038-1040. ZHENG Qianyun,YAN Yuqing,YIN Guoqian, et al. Reconstruction of the large defect on eyelid and periorbital with transfer flap[J]. Inter Eye Sci, 2013, 13(5):1038-1040.
[3] Lowenberg DW, Buntic RF, Buneker GM, et al. Long-term results and costs of muscle flap coverage with Ilizarov bone transport in lower limb salvage[J]. J Orthop Trauma, 2013, 27(10):576-581.
[4] 张建磊,臧成五,陈永祥,等. 游离骨间背侧动脉桡侧穿支皮瓣在手部软组织缺损中的应用[J]. 中华手外科杂志,2016,32(6):447-449. ZHANG Jianlei, ZANG Chengwu, CHEN Yongxiang, et al. The application of free dorsal interosseous artery radial perforator flap in repairing soft tissue defects of the hand[J]. Chin J Hand Surg, 2016, 32(6):447-449.
[5] Heredero S, Solivera J, Garcia B, et al. Osteomyocutaneous peroneal artery perforator flap for reconstruction of the skull base[J]. Br J Oral Maxillofac Surg, 2016, 54(1):99-101.
[6] 汪军,姜会庆,于攀. 眼轮匝肌肌皮瓣修复鼻眶部肿瘤切除后皮肤软组织缺损[J]. 中国美容整形外科杂志,2015,26(9):539-542. WANG Jun, JIANG Huiqing, YU Pan. Repair of soft tissue defect after nasal-orbital tumor resection with orbicularis oculi muscle flap[J]. Chin J Aesth Plast Surg, 2015, 26(9):539-542.
[7] Gurunluoglu R, Shafighi M, Williams SA, et al. Reconstruction of large supra-eyebrow and forehead defects using the hatchet flap principle and sparing sensory nerve branches[J]. Ann Plast Surg, 2012, 68(1):37-42.
[8] 唐冬生,谭晓燕,蹇洪. 对偶斧状皮瓣在上下睑皮肤软组织缺损修复中的应用[J]. 中华整形外科杂志,2014,30(5):385-386.
[9] Huang YS, Chen XX, Yang SX, et al. Preliminary exploration of the clinical features of Chinese patients with skin malignancies and premalignaneies: a retrospective study of 1420 cases from Peking University First Hospital[J]. J Eur Aead Dermatol Venereol, 2013, 27(9):1114-1119.
[10] 刘积东,张斌,林中梅. 旋转皮瓣联合皮下蒂皮瓣修复眶下区皮肤肿瘤术后缺损[J]. 中华整形外科杂志,2015,31(4):309-310.
[11] 燕静杰,杨庆华,刘戈,等. 应用颞浅及眶上滑车上血管为双蒂的额部扩张皮瓣修复面部缺损[J]. 中华整形外科杂志,2014,30(1):18-21. YAN Jingjie, YANG Qinghua, LIU Ge, et al. Reconstruction of facial defects with frontal expanded flaps bipedicled by superficial temple vessels and supraorbital/supratrochlear neurovascular bundles[J]. Chin J Plast Surg, 2014, 30(1):18-21.
[12] Wang ZG, Xu QC, Kuang RX, et al. Principles of hatchet-skin flap for repair of tissue defects on the cheek[J]. Aesthe Plast Surg, 2012, 36(1):163-168.
[13] 李云峰,郑永生,李静平,等. 眶下动脉的血供研究在鼻部组织缺损修复中的应用[J]. 中国美容医学,2007,16(9):1233-1234. LI Yunfeng, ZHENG Yongsheng, LI Jingping, et al. The blood supply study of the infraorbital artery and its application in the nasal tissue defects[J]. Chin J Aesth Med, 2007, 16(9):1233-1234.
[14] 晏丹,黄泽春,张安利,等. 斧形皮瓣在眶周皮肤软组织缺损修复中的应用[J]. 中华医学美学美容杂志,2012,18(6):433-436. YAN Dan, HUANG Zechun, ZHANG Anli, et al. Application of dolabriform flap in repairing periorbital skin and soft tissue defects[J]. Chin J Med Aesth Cosmetol, 2012, 18(6):433-436.
[15] 杨喆,刘伟,李养群,等. 扩张的颈肩峰区锁骨上皮瓣修复面颈部软组织缺损[J]. 中国美容医学,2015,24(9):1-5. YANG Zhe, LIU Wei, LI Yangqun, et al. Pre-expanded cervico-acromial flap based on the supraclavicular artery for resurfacing soft tissue defects of head and neck[J]. Chin J Aesth Med, 2015, 24(9):1-5.
[16] Durgun M, Ozakpinar HR, Sari E, et al. The versatile facial artery perforator-based nasolabial flap in midface reconstruction[J]. J Craniofac Surg, 2015, 26(4):1283-1286.
[17] 张培培,杨超,邢新,等. 面动脉穿支皮瓣修复鼻、唇与颊部皮肤软组织缺损[J]. 中华整形外科杂志,2016,32(1):35-38. ZHANG Peipei, YANG Chao, XING Xin. Reconstruction of soft tissue defects at nose, lip, and cheek with facial artery perforator flaps[J]. Chin J Plast Surg, 2016, 32(1):35-38.
[18] 孙梦妍,朱吉,吕川,等. 改良皮下组织蒂推进瓣修复面中部皮肤缺损[J]. 中国美容整形外科杂志,2016,27(3):136-139. SUN Mengyan, ZHU Ji, LYU Chuan, et al. Repair of midface defects by the modified V-Y advancement flap with subcutaneous pedicle[J]. Chin J Aesth Plast Surg, 2016, 27(3):136-139.
[19] 张瑾,张郎,时荣,等. 扩张后胸三角皮瓣带蒂转移修复老年面颈部术后软组织缺损[J]. 中国老年学杂志,2016,36(9):2209-2210.
[20] Song B, Zhao J, Guo S, et al. Repair of facial scars by the free expanded deltopectoral flap[J]. Plast Reconstr Surg, 2013, 131(2):200-208.

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