面动脉鼻唇沟穿支皮瓣一期修复鼻尖缺损的临床观察

蒋邦红; 何亚楠; 王瑀琨; 祖文轩; 王怀谷; 徐静; 张莉

doi:10.13898/j.cnki.issn.1000-2200.2023.06.009

面动脉鼻唇沟穿支皮瓣一期修复鼻尖缺损的临床观察

Application of facial artery nasolabial perforator flap in one-stage reconstruction of nasal tip defect

摘要

摘要:
目的探讨面动脉鼻唇沟穿支皮瓣对鼻尖缺损一期修复的临床效果。
方法回顾分析因外伤和皮肤肿瘤切除后继发鼻缺损病人36例资料，包含鼻尖在内的多个亚单位缺损。按修复方法不同分为2组，观察组18例，采用面动脉鼻唇沟穿支皮瓣一期修复，对照组18例，采用额部滑车上动脉皮瓣修复。比较2组病人鼻子外形、瘢痕严重程度、供区皮瓣大小及病程时间。
结果2组病人术后鼻尖表现点均有明显体现，差异无统计学意义(P>0.05)，两侧鼻翼及鼻孔的对称度评价中，观察组病人明显较对照组更对称(P < 0.05)。此外，在面积、厚度、柔软度及色素沉着等瘢痕严重程度评分项目中，观察组均低于对照组(P < 0.05~ P < 0.01)。观察组所需供瓣面积更小，且病程时间减少(P < 0.01)。
结论鼻唇沟区组织量充分，皮瓣供区隐蔽，邻近外鼻组织，且血供确切，手术方法较为简单，是累及鼻尖全层缺损一期修复较为理想的方法。

Abstract:
ObjectiveTo investigate the clinical effect of the facial artery nasolabial perforator flap for one-stage reconstruction of the nasal tip defect.
MethodsThirty-six patients with nasal defects were reviewed, as a result of trauma and skin tumor resection, and the defect involved multiple subunits including the nasal tip.The patients were divided into two groups according to repair methods, 18 patients in each group.The observation group received facial artery nasolabial perforator flap for one-stage reconstruction, and the control group received frontal upper trochlear artery flap for reconstruction.Nose shape, scar severity, donor flap size and disease duration were compared between the two groups.
ResultsPerformance point of nasal tip was evident in all the two groups, and the difference was not statistirally significant (P>0.05).In the symmetry evaluation of both nostrils and nostrils, the patients in the observation group were significantly more symmetrical than those in the control group (P < 0.05).The observation group was lower than the control group in the scar severity scores such as area, thickness, softness and pigmentation (P < 0.05 to P < 0.01).The observation group required a smaller donor flap and had a reduced disease duration(P < 0.01).
ConclusionsThe tissue amount of the nasolabial area is sufficient, the supply area is easy to be hidden, djacent to the external nasal tissue, and the blood supply is exact, the operation method is relatively simple, which is an ideal method to complete the one-stage reconstruction of the whole-layer defect of the nasal tip.

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