【摘要】 目的:探讨不同修复方法在头颈部恶性肿瘤术后缺损Ⅰ期修复与重建中的作用,评价其临床效果。方法:1989年1月至1998年12月,我们对258例头颈部恶性肿瘤患者的术后缺损进行了Ⅰ期修复与重建,患者年龄23～81岁,中位年龄51.3岁,男160例,女98例。缺损部位包括:头皮62例,颈部40例,口颊部39例,鼻部29例,唇颏部27例,颧颞部22例,下颌骨20例,舌及口底部12例,其它7例。修复方法:局部皮瓣修复75例;局部皮瓣加游离植皮53例;邻近组织瓣修复加游离植皮47例;肌皮瓣18例;肌皮瓣加局部皮瓣或游离植皮25例;游离组织瓣移植30例;游离组织瓣加邻近组织瓣修复3例;组织代用品7例。结果:全组258例病人,共采用276个皮瓣及组织代用品修复。手术成功224例,手术基本成功23例,手术失败11例。结论:头颈部肿瘤术后Ⅰ期修复与重建可最大限度地减少术后功能障碍和畸形,提高患者生存质量。更多还原

【Abstract】 Objective: To evaluate different methods in one stage reconstruction for head and neck defects after cancer resection. Methods: Between May 1989 and December 1998, 258 patients underwent head and neck reconstruction at one stage using different methods. The ages of the patients ranged from 23 to 81 years with a mean of 51.3 years. One hundred and sixty patients are male and 98 female. The location of the defects were as follows: scalp and skull (62), neck (40), cheek (39), nose (29), lip (27), temporal region (22), mandible (20), tongue and the floor of the mouth (12), and others (7). Local and regional flaps and graftion of split skin was used in 175 patients. The myocutaneous flaps were used in 18 patients. The myocutaneous flaps and regionalflaps w ere used in ２５patients．Thirty－three patients received free flap transplantation for reconstruction．Seven patients underw ent reconstruction w ith im plant m aterials．R esults：Tw o hundred and seventy－six flaps and im plant m aterials w ere used for ２５８patients．The reconstruction has been com pletely successfulin ２２４patients，partly successfulin ２３patients．In the １１failure cases，im plant m aterials w ere the w orst （５out of ７failed ），three m yocutaneous flap，two cutaneous flaps and one free flap failed．C onclusion：The one－stage reconstruction allow s the restoration of function and cosm etic in patients undergoing ablative surgery for advanced head and neck cancer．更多还原