特殊老年患者头皮巨大肿瘤切除后的缺损修复

发布时间：2018-06-20 11:08

本文选题：特殊老年患者 + 头皮巨大肿瘤　；参考：《中国现代医学杂志》2016年04期

【摘要】：目的探讨特殊类型老年患者头皮巨大肿瘤切除后大面积缺损的修复方法和经验。方法本组老年患者共26例,22例患有慢性肺源性心脏病或代谢疾病,身体一般状况较差,4例患有恶性肿瘤。对26例头皮巨大肿瘤进行切除,切除后创面大小10 cm×18 cm~16 cm×24 cm,根据不同的创面特点懫用皮片、轴型皮瓣、扩张皮瓣及游离皮瓣4种不同的方法修复,观察其临床疗效。结果 5例植皮修复创面,2例皮片小部分坏死,随访3例放疗后皮片部分坏死,最终用皮片封闭创面;3例游离皮瓣,2例边缘小部分坏死。1例大部分坏死,创面予皮片修复;5例扩张皮瓣修复创面,3例切口瘢痕较宽,所有老年患者都抱怨治疗的过程太长,扩张器膨胀的过程让其产生不适感;13例轴型皮瓣中1例皮瓣的远端坏死,1例皮瓣切口裂开,移植皮瓣术后放疗未出现坏死。随访3个月~2年,1例肿瘤复发,1例肺癌晚期死亡。结论对于具有合并症或患恶性肿瘤的特殊老年患者,头皮巨大肿瘤切除后的大面积缺损以轴型皮瓣修复为佳,因其手术瘢痕不明显,皮瓣外观和功能均较满意且治疗时间相对短,可为合并症或者肿瘤的治疗做好准备并赢得宝贵时间。
[Abstract]:Objective to investigate the repair method and experience of large area defect after scalp giant tumor resection in elderly patients with special type. Methods Twenty-two elderly patients with chronic pulmonary heart disease or metabolic disease and 4 patients with malignant tumor were enrolled in this study. 26 cases of giant scalp tumor were resected. The wound size was 10 cm 脳 18 cm~16 cm 脳 24 cm. According to the different wound characteristics, the wounds were repaired with four different methods: skin grafts, axial flaps, expanded flaps and free flaps. Results there were 2 cases of small necrosis of skin grafts, 3 cases of partial necrosis of skin grafts after radiotherapy, 3 cases of free skin flap and 2 cases of marginal necrosis of 2 cases. The wound was repaired by skin grafts in 5 cases with expanded skin flap and 3 cases with wide scar. All the elderly patients complained that the process of treatment was too long. The distally necrotic skin flap in 1 case of distally necrotic flap in 1 case, and no necrosis occurred after radiotherapy of the transplanted flap in 1 case, the distally necrotic flap in 1 case caused the distally necrotic flap in 13 cases. One case of tumor recurrence and one case of late death of lung cancer were followed up for 3 months to 2 years. Conclusion for the special elderly patients with complicated or malignant tumor, the axial flap is the best way to repair the large area defect after the excision of giant tumor of scalp, because the scar of operation is not obvious. The appearance and function of the flap are satisfactory and the treatment time is relatively short. It can be used to prepare for the treatment of complications or tumors and to gain valuable time.
【作者单位】：广西医科大学第一附属医院急诊科;广西医科大学第一附属医院整形美容外科;
【分类号】：R739.5

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