本文選題：皮瓣　切入點(diǎn)：足踝部　出處：《吉林大學(xué)》2012年碩士論文

【摘要】：目的：通過總結(jié)我科自1999年至2010年間所收治的足踝部惡性黑色素瘤患者的臨床資料和病例隨訪，比較不同類型皮瓣手術(shù)的治療效果和遠(yuǎn)期存活率，討論足踝部惡性黑色素瘤的較為理想的治療方案，積累臨床經(jīng)驗(yàn)，為今后相關(guān)疾病的診治提供理論和技術(shù)支持。 方法：1999年至2010年，我科共收治足踝部惡性黑色素瘤患者21例。通過對此21例患者臨床資料的分析總結(jié)，以及術(shù)后遠(yuǎn)期隨訪患者存活情況、腫瘤有無復(fù)發(fā)及轉(zhuǎn)移，以及皮瓣生長及感覺恢復(fù)情況，探討以病灶擴(kuò)大切除、皮瓣修復(fù)軟組織缺損的方法治療足踝部惡性黑色素瘤的可行性。 結(jié)果：通過回顧臨床資料及病例隨訪總結(jié)出該治療方案的遠(yuǎn)期療效（1）所有患者術(shù)后病理結(jié)果回報均為惡性黑色素瘤，且切緣未見癌細(xì)胞；（2）7例死亡（其中1例因心腦血管疾病死亡，3例就診時已發(fā)現(xiàn)腹股溝淋巴結(jié)轉(zhuǎn)移，后發(fā)生遠(yuǎn)處轉(zhuǎn)移，另3例分別于術(shù)后6個月、13個月及22個月發(fā)生復(fù)發(fā)及轉(zhuǎn)移）；（3）各種皮瓣均成活良好，耐磨，大部分患者皮瓣具有保護(hù)性感覺。（4）患者主訴皮瓣不影響穿鞋、行走等日常生活活動。 結(jié)論：（1）早期足踝部惡性黑色素瘤通過病灶擴(kuò)大切除，腫瘤復(fù)發(fā)及轉(zhuǎn)移概率未見增高，保肢具有臨床意義。（2）應(yīng)用皮瓣手術(shù)可以很好的解決腫物切除后創(chuàng)面軟組織缺損的問題，皮瓣在外形及功能上能達(dá)到較好的修復(fù)效果。（3）對于足踝部早期惡性黑色素瘤，腫物擴(kuò)大切除，皮瓣修復(fù)軟組織缺損的手術(shù)方法保肢成功率較高，輔以化療及生物治療，預(yù)后效果更好。（4）保肢手術(shù)不僅最大程度的保留了肢體，，且有助于減輕患者的經(jīng)濟(jì)負(fù)擔(dān)及心理負(fù)擔(dān)，利于病情恢復(fù)。
[Abstract]:Objective: to summarize the clinical data and follow-up of patients with ankle malignant melanoma treated in our department from 1999 to 2010, and to compare the therapeutic effect and long-term survival rate of different types of flap operation. To discuss the ideal treatment for malignant melanoma of foot and ankle, accumulate clinical experience and provide theoretical and technical support for the diagnosis and treatment of related diseases in the future. Methods: from 1999 to 2010, 21 patients with malignant melanoma of ankle and foot were treated in our department. As well as the growth and sensory recovery of the skin flap, the feasibility of the treatment of malignant melanoma of foot and ankle with expanded resection of lesion and repair of soft tissue defect was discussed. Results: by reviewing the clinical data and following up the cases, we concluded that the long-term curative effect of this treatment regimen was 1) all the patients had malignant melanoma after operation. There were 7 cases of cancer cell death (1 case died of cardiovascular and cerebrovascular disease 3 cases had found inguinal lymph node metastasis, and then distant metastasis occurred). The other 3 cases had recurrence and metastasis at 6 months, 13 months and 22 months after operation respectively. All kinds of flaps survived well and were wear-resistant. Most of them had protective sensation. 4) the patients complained that the skin flap did not affect the activities of daily life such as wearing shoes and walking. Conclusion (1) in the early stage of malignant melanoma of ankle and foot, the probability of recurrence and metastasis was not increased, and the recurrence and metastasis rate of the tumor was not increased. (2) the flap operation can solve the problem of soft tissue defect of the wound after resection of tumor. The shape and function of the flap can reach a better repair effect.) for the early malignant melanoma of the ankle and foot, the surgical method of extensive excision of the tumor and the repair of the soft tissue defect by the flap has a higher success rate of limb salvage, and is supplemented with chemotherapy and biological therapy. The prognosis is better. (4) limb salvage surgery not only saves the limbs to the greatest extent, but also helps to reduce the economic and psychological burden of the patients, and is conducive to the recovery of the disease.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R739.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 繆冠,童學(xué)波,俞輝國,張偉濱;肢體惡性骨腫瘤保肢手術(shù)研究進(jìn)展[J];國外醫(yī)學(xué)(骨科學(xué)分冊);2005年03期

2 彭艷斌;萬圣祥;肖穎峰;王擁軍;周U喐

本文編號：1664106