阿迪力江·赛买提 张思敏 买买提吐逊·吐尔地

[摘要]目的：评价结合 Shelby G及Federico的设计方案的菱形瓣修复颌面部缺损的应用效果。方法：近三年以来，笔者科室结合 Shelby G及Federico的菱形瓣设计方案，对22例颌面颈部不同类型疾病手术治疗过程中形成的继发性缺损进行修补缺损。入院后进行常规检查排除手术禁忌证，完善术前准备后安排手术治疗，按照病变累及部位、大小等因素确定麻醉方法;手术治疗后进行常规换药、术后6～7d拆除缝合线。结果：21例患者术后均一期愈合，无感染、裂开等情况，1例患者皮瓣坏死换药处理后二期愈合，均无供皮区畸形等情况，术后6～7d拆除缝合线，患者满意手术效果。结论：结合Shelby G及Federico的菱形瓣设计方案，尤其顶角在30°～45°范围内的菱形瓣转移修补方案，修复颌面颈部小范围组织缺损效果明显，满意度高，可临床推广应用。

[关键词]菱形瓣;颌面颈部;皮肤病变;组织缺损;修复

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）07-0086-03

Clinical Analysis of 22 Cases of Maxillofacial and Neck Defects Repaired with Rhombus Flap Design

Adilijiang·SAIMAITI，ZHANG Si-min，Maimaitituxun·TUERDI

[Department of Trauma and orthognathous Surgery of Maxillofacial， the Frist Affiliated Hospital of Xinjiang Medical University（Affiliated Hospital Of Stomatology），Urumqi 830011，Xinjiang，China]

Abstract： Objective To evaluate  the new formed rhomboid flap that repairing neck and facial defects combined the design of Shelby G and Federico. Methods  In the past three years，we used the new formed rhomboid flap repair 22 patients with neck and facial defects， all patients were underwent preoperation evaluation by conventional test，according to the lesions location，size choose anesthesia method，after surgery performend routine medical procedure，the stitcheds were removed 6-7days after surgery. Results  21 of the patients were healed in the first stage without infection and split. One patient was healed in the second stage after the treatment of flap necrosis. All the patients had no deformity of skin donor area. The suture was removed 6-7 after the operation， and the patients were satisfied with the operation results. Conclusion  The combined rhomboid flap can be used in the repair of neck and facial defects. At the same time， it is necessary to comprehensively analyze the nature， size and location of the lesions， The appropriate design method of rhomboid flap could improve the operation efficiency and reduce the operation trauma.

Key words： rhomboid flap; neck and facial;skin lesion;defect;repair

在臨床工作中，各种原因引起的颌面颈部缺损的修补是一种挑战性的工作，简单的修补关闭创面远远满足不了广大患者的要求。在这方面，国内外学者做了大量的临床工作及实验研究之后提出了不同的修补方法，如：V-Y修补、双叶瓣、菱形瓣、鼻唇沟瓣等局部皮瓣[1]。菱形瓣是在全身各处不同创面修复方面应用较多的皮瓣，面部的不同部位使用后也得到了满意效果。国外学者对菱形瓣在原有的基础上进行研究并总结出不同类型的菱形皮瓣设计方案。……