| 摘要: |
| 目的:评价吻合血管神经足展肌游离移植治疗晚期面瘫的远期疗效。方法:对1990年3月至2006年11月接受该术式的患者共28例进行术后随访1～16年，中位随访时间4年，分析患者手术前后标准头正位照片，采用多伦多评价系统(T-FGS)和面神经功能指数(FNFI)评价面神经功能，并对移植肌存活状况、面宽、瘢痕、供足功能等情况加以分析比较。结果:所有患者术后均获得理想的静态对称，随访发现所有患者均有移植肌的随意收缩运动，其中22例获理想的微笑。与术前相比，患者术后T-FGS得分提高了(27±7.2)分，FNFI值提高了(57±10.7)%，差异有统计学意义(P<0.05)；术后患者瘢痕隐蔽，供足无遗留功能障碍。结论:吻合血管神经足展肌游离移植治疗晚期面瘫术后远期效果理想，供区无任何功能障碍，值得推广。 |
| 关键词: 足展肌 游离移植 晚期面瘫 远期疗效评价 |
| DOI：10.3724/SP.J.1008.2008.00958 |
| 投稿时间：2007-03-12修订日期：2008-07-03 |
| 基金项目:上海市卫生系统百名跨世纪优秀学科带头人培养计划(076). |
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| Free transfer of abductor hallucis combined with anastomosis of blood vessels and nerves for established facial paralysis:assessment of long term effectiveness |
| LIN Quan,JIANG Hua* |
| (Department of Plastic Surgery,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China) |
| Abstract: |
| Objective:To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis.Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up.The follow-up period was 1 to 16 years,with a median period of 4 years.The facial pictures of frontal view were analyzed before and after operation.T-FGS and facial nerve function index (FNFI) were used to evaluate the facial nerve function before and after operation.Meanwhile,the survival of the graft,the width of the face,the scar,and the function of the foot were analyzed and compared.Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles.Twenty-two patients obtained ideal smiling faces.The T-FGS score increased by (27±7.2) points and the score of FNFI increased by (57±10.7)% after transplantation (P<0.05).Furthermore,the scars on the face were well concealed and there was no functional impairment in the donor foots.Conclusion: Free transfer of abductor hallucis muscle plus anastomosis of blood vessels and nerves has satisfactory long term outcome in dynamic reanimation of established facial paralysis,without functional impairment to the donor foot and is worth of popularizing. |
| Key words: abductor hallucis muscle free transfer the established facial paralysis evaluation of curative effect |
