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目的探讨使用交叉唇瓣修复上唇缺损术中同期吻合唇动脉,促进皮瓣成活,以达到缩短住院时间的可行性及疗效。方法 2010年8月-2014年1月,对11例上唇缺损患者采用交叉唇瓣移位修复,同期吻合上、下唇动脉。其中男9例,女2例;年龄13~70岁,平均62岁。其中6例为上唇肿瘤切除后,2例为动物咬伤致上唇部分缺损,3例为唇裂术后继发上唇过紧畸形,行瘢痕切除修复术。上唇缺损范围为宽度1.5~4.0 cm,高度1.8~3.5 cm;唇瓣切取宽度为1.5~3.2 cm,高度为1.5~3.0 cm。下唇供区直接拉拢缝合。结果术后唇瓣顺利成活,创面Ⅰ期愈合;术后5 d顺利完成断蒂术,断蒂后唇瓣未发生水疱、脱屑及其他静脉回流障碍并发症。除1例糖尿病患者切口延期愈合(术后2周愈合)外,其余患者切口均Ⅰ期愈合。11例均获随访,随访时间5~24个月,平均11个月。患者表情、进食、语言功能接近正常。术后12个月77.8%(7/9)患者交叉唇瓣轻触觉恢复。供区外观无明显畸形。结论采用交叉唇瓣修复上唇缺损同期吻合上、下唇动脉,可缩短断蒂时间及住院时间,减轻患者两期手术间的不适。
Objective To explore the feasibility and efficacy of using cross-lip to repair anastomosis lip arteries in the same period of upper lip defect and to promote flap survival in order to shorten the length of hospital stay. Methods From Aug. 2010 to Jan. 2014, 11 cases of upper lip defect were treated with cross-labial displacement and anastomosed with the upper and lower lip arteries. Including 9 males and 2 females; aged 13 to 70 years, mean 62 years. Of the 6 cases, the upper lip tumors were resected, 2 were upper bite defects caused by animal bites, and 3 were severe secondary lip recurrences after cleft lip surgery. Scar resection and repair were performed. The width of the upper lip is 1.5-4.0 cm in width and 1.8-3.5 cm in height. The width of the upper lip is 1.5-3.2 cm and the height is 1.5-3.0 cm. Lower lip for the area directly draw suture. Results The lip was successfully survived and the wound healed in the first stage. The pedicle screw was completed 5 days after the operation, and no lip, blister and other complications of venous return disorder occurred after the pedicle. Except for one case of diabetic patients with delayed incision healing (healed after 2 weeks), all other incisions healed first-stage. Eleven patients were followed up for 5-24 months with an average of 11 months. Patient expression, eating, language function close to normal. At 12 months after operation, 77.8% (7/9) of the patients had cross-sectional soft touch recovery. No apparent deformity for the appearance of the area. Conclusions Using the cross lip to repair the upper lip defect coincides with the upper and lower lip arteries in the same period can shorten the time of pedicle pedicle and hospital stay and relieve the discomfort between the two surgical stages.