發(fā)布時間：2018-03-02 10:49

  本文關鍵詞： 原發(fā)灶對側頦下島狀肌皮瓣 口腔鱗狀細胞癌 組織缺損 修復 可行性　出處：《河北醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討原發(fā)灶對側頦下島狀肌皮瓣應用于口腔鱗狀細胞癌(oral squamous cell carcinomas OSCC)術后組織缺損修復的可行性,以期增加臨床工作者的選擇。方法:河北醫(yī)科大學第四醫(yī)院口腔科2013年11月-2016年1月之間收治的14例患者,12例患者為舌部腫物,2例患者為上牙齦腫物,術前經(jīng)病理證實為鱗狀細胞癌。年齡45-71歲。頜頸CT/MRI顯示原發(fā)灶同側有可疑轉移淋巴結組織,而對側沒有。均采用原發(fā)灶對側頦下島狀肌皮瓣修復術后組織缺損。通過隨訪觀察,分析皮瓣的成活率、修復效果、術后并發(fā)癥及腫瘤的復發(fā)和轉移情況,判斷原發(fā)灶對側頦下島狀肌皮瓣的適應癥,指導臨床應用。結果:14例患者中出現(xiàn)皮瓣壞死現(xiàn)象0例,皮瓣成活率為100%。術后出現(xiàn)頸部血腫繼而并發(fā)創(chuàng)腔感染1例。由面神經(jīng)下頜緣支損傷產生的相應側口角下垂癥狀0例;下唇外翻及貓耳畸形0例。隨訪時間失訪1例,死亡1例。局部復發(fā)及頸部轉移0例。結論:原發(fā)灶對側頦下島狀肌皮瓣屬于頦下島狀肌皮瓣的一種,是一種可靠的、切取相對簡單的、修復效果較好的、成活率較高的且術后并發(fā)癥少的皮瓣;能夠用于原發(fā)灶同側有可疑淋巴結轉移患者;如果術前檢查高度懷疑對側有可疑淋巴結轉移的患者,應慎用。
[Abstract]:Objective: to investigate the feasibility of using the contralateral submental island myocutaneous flap to repair the tissue defect after oral squamous cell carcinomas OSCC. Methods: from November 2013 to January 2016, 14 patients were admitted to the Department of Stomatology, 4th Hospital of Hebei Medical University. 12 patients with tongue tumor and 2 patients with upper gingival mass, were selected from the Department of Stomatology of 4th Hospital of Hebei Medical University from November 2013 to January 2016. Squamous cell carcinoma was proved by pathology before operation. The age was 45-71 years old. CT/MRI of maxillary neck showed suspected metastatic lymph node tissue on the ipsilateral side of the primary lesion, but not on the other side. All patients were treated with the primary contralateral submental island myocutaneous flap to repair the postoperative tissue defect. The survival rate, repair effect, postoperative complications and tumor recurrence and metastasis of the flap were analyzed, and the indications of the primary locus contralateral submental island myocutaneous flap were determined to guide clinical application. The survival rate of the flap was 100. There was 1 case of cervical hematoma and then complicated with wound cavity infection. There were 0 cases of drooping symptoms of the corresponding side of mouth angle caused by the injury of the mandibular marginal branch of the facial nerve, 0 cases of lower lip valgus and cat's ear malformation. One case died. Local recurrence and cervical metastasis were found in 0 cases. Conclusion: the primary contralateral submental island myocutaneous flap is a kind of submental island myocutaneous flap. The flap with high survival rate and less postoperative complications can be used in patients with ipsilateral suspected lymph node metastasis.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R739.8

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