摘要目的 探讨分析3种游离股前外侧皮瓣在口腔软组织缺损修复中的临床特点与治疗效果。方法 2008年12月至2010年12月收治67例口腔肿瘤患者，切除肿瘤的同时，应用游离股前外侧皮瓣修复缺损处，包括舌、颊、牙龈、口底，通常将皮瓣的旋股外侧动脉降支与受区的颌外动脉或甲状腺上动脉吻合，伴行静脉与受区的面总静脉或颈外静脉吻合。根据游离股前外侧皮瓣的厚度将其分成3种类型：股前外侧肌皮瓣、股前外侧脂肪筋膜皮瓣和薄型股前外侧皮瓣。结果 67例中股前外侧肌皮瓣为35例，股前外侧脂肪筋膜皮瓣17例，薄型股前外侧皮瓣15例。66例皮瓣存活，成功率为98.5％，其中1例糖尿病患者皮瓣发生小部分坏死，经清创换药后痊愈；1例皮瓣完全坏死。67例皮瓣中41例吻合2条静脉，26例吻合1条静脉。8例出现血管危象：6例为静脉血栓（5例抢救成功、1例皮瓣完全坏死），1例为术区血肿，1例为穿支血管扭转，经过相应处理，血管危象均得到缓解。术后随访2～ 24个月，平均8.7个月，受区组织缺损修复效果满意，供区创面愈合良好。结论 游离股前外侧皮瓣的受区功能良好，供区并发症少，是一种修复口腔软组织缺损的较为理想的方法。

abstractsObjective To assess the clinical features and therapeutic efficacy of anterolateral thigh (ALT) flaps for the intraoral defects reconstruction. Methods The clinicopathologic data of 67 cases with oral tumors were obtained from School of Stomatology, Nanjing University Medical Center from Dec. 2008 to Dec. 2010. All the patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free anterolateral thigh flaps. The defects included the tongue, buccal, gingival, mouth floor, and so on. The descending branch of lateral femoral circumflex artery was anastomosed to the external maxillary artery or superior thyroid artery ; the vein was anastomosed to the common facial vein or external jugular vein. The flaps were divided into three types : musculocutaneous ALT flap, fasciocutaneous ALT flap and thinned ALT flap. Results There were 38 male patients and 29 female. The anterolateral thigh flaps included 35 musculocutaneous flaps, 17 fasciocutaneous flaps and 15 thinned flaps. The success rate was 98.5％ (66/67). Partial necrosis happened in one case with diabete, which healed after debridement and dressing. 1 flap was totally necrosis. Double venous anastomosis was performed in 41 flaps, and one venous anastomosis was performed in 26 flaps. 8 patients required operative exploration in the perioperative period including 6 flaps with thrombotic events (5 flaps were complete survival after the salvages, and 1 flap was failure), 1 flap with hematoma, and 1 flap with twisting of perforator. The followup period ranged from 2 to 24 months( mean, 8.7 months). The result was satisfied. The donor sites were closed directly in all patients, and the wounds healed uneventfully. Conclusions The free anterolateral thigh flap is an ideal soft tissue flap for the intraoral defects reconstruction with good functional result at recipient area and less morbidity at the donor site.