异种脱细胞真皮基质修复口腔颊部肿瘤切除后组织缺损的临床观察

张圃,王欣,杨新杰,孙沫逸,李建虎,马秦,雷德林

[摘要]目的：探讨异种脱细胞真皮在口腔颊部肿瘤切除后组织缺损修复中的应用方法、效果及长期观察的评价。方法：收集2006年4月～2009年5月口腔颊部肿瘤切除后组织缺损应用异种脱细胞真皮基质修复膜进行修复的19例患者资料。术后进行追踪随访和功能评价。结果：术后随访 6～24个月，平均15个月。19例患者的组织缺损修复均获得成功，术后7～10天均未见修复膜脱落，愈合良好，植入异种生物膜部位逐渐为自体膜组织长入。长期观察，活化后的修复膜在软组织部位受植床存在一定的收缩。结论：生物膜修复组织缺损的机理与传统的植皮方法不同，是生物支架功能，异种脱细胞真皮基质适合口腔颊部肿瘤切除后浅、中层组织缺损的修复。

[关键词]口腔；颊；缺损；修复；异种脱细胞真皮基质；生物膜

[中图分类号]R782 [文献标识码]A [文章编号]1008-6455（2012）04-0570-03

Acellular dermal matrix for repair of buccal defects after tumor resection

ZHANG Pu,WANG Xin,YANG Xin-jie,SUN Mo-yi,LI Jian-hu,MA Qin,LEI De-lin

(Department of Oral and Maxiillofacial Surgery,Stomatological College,The Fourth Military Medical University,Xi'an 710032,Shaanxi,China)

Abstract:ObjectiveTo evaluate the clinical management and evolution of repairments for buccal defects after tumor resection in bio-materials．Methods19 cases with oral buccal mucosal tissue defects were treated with heterogeneous acellular dermalmatrix.All patients were followed up for 10 to 24 months and assessed the ruction on postoperatively.Results19patients underwenttransplantation survived were by assessed 7 to 10 days postoerafively.Long-term follow up revealed mucosa wound contraction in soft recipient areas to some degree． ConclusionHeterogeneous acellular dermal matrix is a valuable biomaterial for repairing oral mucosal defects through covering and protecting wound surface early,which shortens the healing time ofwound surface and decreases occurrence of production of scar.

Key words:oral;buccal;defects;reconstraction;heterogeneous acellular dermal matrix;biomembrane

颊部肿瘤，尤其是颊部鳞癌，是口腔常见病，治疗方法主要为肿瘤切除/扩大切除，手术造成颊部软组织缺损。目前颊部肿瘤性缺损修复方法包括自体皮肤移植、邻近粘膜瓣转移修复、颈阔肌肌皮瓣移位修复、胸大肌肌皮瓣移位修复，游离前臂皮瓣移植修复。近年来非自体组织植入，主要包括生物膜等植入修复颊部肿瘤型缺损是一个新的技术手段。现报道笔者对异种脱细胞真皮生物膜修复颊部缺损的临床经过和评价的进行的研究。

1资料和方法

1.1 临床资料：2006年4月～2009年5月在我科进行的口腔颊部肿瘤切除后组织缺损同期应用异种脱细胞真皮基质生物膜修复软组织缺损19例（男11例，女8例），年龄37～76岁，平均52岁。……