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面部皮膚惡性腫瘤綜合治療分析

發(fā)布時(shí)間:2018-11-27 11:23
【摘要】:目的:探討面部皮膚惡性腫瘤綜合治療的臨床療效及其術(shù)后功能形態(tài)的恢復(fù),能更好的指導(dǎo)我們的臨床實(shí)踐工作,以手術(shù)治療為主的綜合治療這種較為理想的治療方式能在臨床上能得到積極的推廣運(yùn)用。方法:回顧性分析我科2004年9月至2010年9月的面部惡性腫瘤臨床資料72例,基底細(xì)胞癌52例,鱗癌16例,其它類(lèi)型(Bowen病、表淺黑色素瘤、瘢痕癌等)4例,男43例,女29例;年齡30-85歲,以61-70歲多見(jiàn),平均67歲,其中病灶位于額部12例,眼周23例、鼻部18例,顳部9例,顴頰部7例,口周3例,其中≤30歲1例,31-40歲2例,41-50歲5例,51-60歲14例,61-70歲28例,71-80歲16例,≥81歲以上6例。根據(jù)病灶的部位和范圍,擴(kuò)大切除病灶后行直接對(duì)位縫合,局部皮瓣轉(zhuǎn)移,皮片移植,局部皮瓣+皮片移植為主的手術(shù)方式并術(shù)后輔助放療或化療的綜合治療。結(jié)果:72例研究資料中1年后3例基底細(xì)胞癌復(fù)發(fā),鱗癌無(wú)復(fù)發(fā),復(fù)查全身CT后發(fā)現(xiàn)有1例發(fā)生遠(yuǎn)處轉(zhuǎn)移,其它類(lèi)型患者3年生存率較好,其余患者皮片或皮瓣全部成活,切口愈合良好,電話(huà)隨訪(fǎng)1-3年,患者術(shù)后外形與功能良好,除1例因植皮后有輕度的色素沉著外,其它患者美容效果較好,未引起繼發(fā)畸形,醫(yī)患雙方對(duì)手術(shù)效果均感較滿(mǎn)意,在本組中發(fā)現(xiàn)基底細(xì)胞癌組、鱗癌組和其它組在手術(shù)方式治療上無(wú)明顯的差異性。結(jié)論:早期診斷、早期治療是治療面部惡性腫瘤的根本所在,面部惡性腫瘤以手術(shù)為主的綜合治療有較好的臨床效果,可根據(jù)患者病灶情況不同滿(mǎn)足個(gè)體化綜合治療方案,以最佳的修復(fù)方式來(lái)滿(mǎn)足患者的病情,不僅可以從根本上清除病灶,也可兼顧患者術(shù)后其功能和形態(tài)的完美統(tǒng)一。
[Abstract]:Objective: to explore the clinical effect of comprehensive treatment of facial malignant tumors and the recovery of functional morphology after operation, so as to better guide our clinical practice. The more ideal treatment is surgical treatment, which can be popularized and applied in clinic. Methods: from September 2004 to September 2010, 72 cases of malignant tumor of face, 52 cases of basal cell carcinoma, 16 cases of squamous cell carcinoma, 4 cases of other types (Bowen disease, superficial melanoma, scar carcinoma, etc.) were retrospectively analyzed. The age ranged from 30 to 85 years, with an average age of 67 years. The lesions were located in frontal region in 12 cases, around eye in 23 cases, nose in 18 cases, temporal part in 9 cases, zygomatic-buccal part in 7 cases, perioral in 3 cases, in which 1 case was 鈮,

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