个体化皮瓣在舌再造中的临床应用

目的依照头颈肿瘤外科修复重建原则，给予舌癌根治术后，采用个体化皮瓣进行舌再造，使患者的吞咽及语言功能早日恢复，提高患者对手术的依从性，最大程度的减少精神创伤。方法对67例舌鳞癌患者在根治术中应用皮瓣移位或皮瓣移植完成修复重建，在皮瓣设计上采取个体化，并从患者术后恢复情况、并发症发生情况、对手术的依从性及其可能产生的精神创伤等方面进行判定及分析。结果术后舌创面Ⅰ期愈合67例，1例血管栓塞患者抢救成功，其他无不良并发症，修复成活率为100%。再造舌外形大部分良好，吞咽功能恢复正常，语言功能恢复优或良，患者心理状况良好。结论个体化皮瓣进行舌再造术的成功率高，并发症发生率低，功能恢复良好，且患者的依从性高，精神创伤小，值得推广。

Clinical Application of Individuation Skin Flap in Tongue Reconstruction

Objective To explore the application of individuation skin flap in tongue reconstruction,which may make a patient’s swallowing and language function recover soon,increase a patient’s compliance to surgery,and reduce a patient’s mental trauma to the most degree.Method Sixty-seven cases of patients with tongue squamous cell carcinoma were given radical surgery and adopted by implementing individuation skin flap shift and transplantation for tongue reconstruction.The results of postoperative recovery situation,the occurrence of complications,surgical compliance,and the possible mental trauma of the patients were judged and analyzed.Results Sixty-seven cases were healed up during I period of surface wound.Thrombosis occurred in 1 patient,while he was rescued successfully.The other patients had no complications.Survival rate of skip flap is 100%.Most of the recreated tongue’s shapes were good.Swallowing function returned to normal,and language functional recovery was excellent or good.Patient’s psychological situation was good.Conclusion The surgery of individuation skin flap in tongue reconstruction showed high success rate with low incidence of complications,satisfactory functional recovery,and high compliance and minimal trauma for patients.