异种脱细胞真皮基质修复膜在组织缺损修复中的应用

发布时间：2018-04-18 17:44

本文选题：异种脱细胞真皮基质 + 修复膜　；参考：《临床耳鼻咽喉头颈外科杂志》2014年17期

【摘要】：目的:观察应用异种脱细胞真皮基质(ADM)修复膜(或联合转移肌瓣)修复82例头颈肿瘤切除后组织缺损的近远期效果。方法:对82例头颈肿瘤切除后组织缺损应用异种ADM修复膜(或联合转移肌瓣)进行修复,其中65例直接以修复膜覆盖黏膜缺损的创面,另17例将修复膜被覆于转移的肌肉组织瓣表面。53例于术后2~4周加行放疗。分别于术后1、3、6、12、18、24、30、36、48及60个月进行随访,电子喉镜下观察手术部位的修复情况以及患者的呼吸、吞咽、发声等功能。结果:77例患者手术切口Ⅰ期愈合,另5例术后发生伤口感染,经引流、局部换药后Ⅱ期愈合;均顺利拔除气管套管及胃管,无局部瘢痕狭窄等发生。随访满1、3及5年者分别有78、49和14例,其中加行术后放疗者分别有53、32和12例。局部病变静止者均未发现排斥、过敏等反应。结论:应用异种ADM修复膜(或联合转移肌瓣)修复头颈肿瘤切除后组织缺损具有相对简便易行、手术安全边缘足够、器官功能保存较好、喉狭窄发生率较低等优点,近远期修复效果均十分确切。
[Abstract]:Objective: to observe the short and long term effect of repairing 82 cases of head and neck tumor tissue defect by heterologous acellular dermal matrix (ADM) repair membrane (or combined with metastatic muscle flap).Methods: 82 cases of head and neck tumor tissue defects were repaired with xenogeneic ADM repair membrane (or combined with metastatic muscle flap), of which 65 cases were directly covered with membrane to cover the mucosal defect wound.In the other 17 cases, the repair membrane was coated on the surface of the metastatic muscle flap. 53 cases were treated with radiotherapy 2 weeks after operation.The patients were followed-up for 48 and 60 months after operation. The repair of the operation site and the functions of breathing, swallowing and vocalization were observed under electronic laryngoscope.Results the wound healed in first stage in 77 patients, infection occurred in 5 cases after operation, and the second stage healed after drainage and local dressing change. The trachea cannula and gastric tube were removed successfully and no local scar stenosis occurred.7849 and 14 cases were followed up for 1 and 5 years respectively, of which 53 cases were treated with postoperative radiotherapy and 12 cases were treated with postoperative radiotherapy.No rejection, anaphylaxis and other reactions were found in patients with static local lesions.Conclusion: the repair of head and neck tumor tissue defect by ADM repair membrane (or combined with metastatic muscle flap) has the advantages of relatively simple, safe edge, good preservation of organ function and low incidence of laryngeal stenosis.The effect of short-and long-term restoration is very accurate.
【作者单位】：西安交通大学医学院第一附属医院耳鼻咽喉头颈外科;
【分类号】：R762

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