口腔医学研究

口腔医学研究 ›› 2025, Vol. 41 ›› Issue (5): 386-390.DOI: 10.13701/j.cnki.kqyxyj.2025.05.005

• 口腔颌面外科学研究 • 上一篇    下一篇

90例腓骨肌皮瓣使用不同厚度重建钛板修复下颌骨缺损的回顾性研究

孙亚威, 吴朱昊, 陈欣, 蒲玉梅, 孙国文*   

  1. 南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,南京大学口腔医学研究所 江苏 南京 210008
  • 收稿日期:2024-12-30 出版日期:2025-05-28 发布日期:2025-05-26
  • 通讯作者: *孙国文,E-mail:238957@sina.com
  • 作者简介:孙亚威(1996~ ),男,山东临沂人,硕士,医师,研究方向:口腔颌面部肿瘤修复重建。
  • 基金资助:
    南京市卫生科技发展项目资金项目(编号:YKK22183)

Retrospective Study on 90 Cases of Mandibular Defects Repaired with Fibular Flap with Different Thicknesses of Reconstruction Titanium Plates

SUN Yawei, WU Zhuhao, CHEN Xin, PU Yumei, SUN Guowen*   

  1. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China
  • Received:2024-12-30 Online:2025-05-28 Published:2025-05-26

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摘要： 目的: 研究不同厚度重建钛板对腓骨肌皮瓣同期修复下颌骨缺损患者术后临床效果的影响。方法: 回顾分析2018年1月~2024年6月南京市口腔医院口腔颌面外科一病区收治的因恶性肿瘤导致的下颌骨缺损,并同期进行腓骨肌皮瓣修复患者的临床信息及随访记录;将所收集的数据使用SPSS 24.0软件包进行统计分析。结果: 最终纳入90例随访信息完整的患者。所有患者中,术后并发症共发生9例,术后9个月为中位发生时间。单因素分析时,术后放疗(P＜0.002)与术后并发症发生密切相关。多因素分析发现,术后放疗(P=0.015)为患者发生术后并发症的独立危险因素。术后行放疗者共19例,其中次重建钛板组(厚度2.0 mm)12例,术后并发症发生率为8.3%(1/12);重建钛板组(厚度≥2.5 mm)7例,术后并发症发生率为71.4%(5/7),两组间比较差异有统计学意义(P=0.019)。结论: 术后放疗会显著提高腓骨肌皮瓣修复下颌骨缺损术后并发症的发生率,术后6~18个月应该予以密切随访;使用不同厚度重建钛板对腓骨肌皮瓣修复下颌骨缺损患者术后并发症的发生无明显影响,但对于有预期进行术后放疗的患者,应尽量使用次重建钛板固定,以降低术后并发症的发生率。

关键词: 腓骨肌皮瓣, 下颌骨重建, 重建钛板, 并发症, 放射治疗

Abstract: Objective: To investigate the effect of different thickness of reconstruction titanium plate on the clinical results of reconstruction of mandibular defects with fibular flap. Methods: A retrospective analysis was conducted on the clinical information and follow-up records of patients with mandibular defects caused by malignant tumors admitted to the First Ward of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital from January 2018 to June 2024 and repaired with fibular musculocutaneous flaps at the same time. Results: A total of 90 patients with complete follow-up information were included. Postoperative complications occurred in 9 patients with a median time of 9 months. On univariate analysis, postoperative radiotherapy (P<0.002) was significantly associated with postoperative complications. Multivariate analysis showed that postoperative radiotherapy (P=0.015) was an independent risk factor for postoperative complications. A total of 19 patients received postoperative radiotherapy, including 12 patients in the sub-reconstruction titanium plate group (thickness 2.0 mm). The incidence of long-term complications was 8.3% (1/12). There were 7 patients in the reconstruction plate group (thickness≥2.5 mm), and the incidence of long-term complications was 71.4% (5/7). There was significant difference between the two groups (P=0.019). Conclusion: Postoperative radiotherapy can significantly increase the incidence of complications after mandibular defect reconstruction with fibular flap. Close follow-up is necessary for 6-18 months after surgery. The use of different thickness reconstruction titanium plates has no significant effect on the occurrence of postoperative complications in patients with mandibular defects repaired with fibular flap. However, for patients who are expected to undergo postoperative radiotherapy, the use of sub-reconstruction titanium plates should be tried to reduce the incidence of postoperative complications.

Key words: fibular flap, mandibular reconstruction, reconstruction titanium plate, complications, radiation therapy