發(fā)布時間：2018-04-18 17:44

  本文選題：異種脫細胞真皮基質(zhì) + 修復膜��； 參考：《臨床耳鼻咽喉頭頸外科雜志》2014年17期

【摘要】：目的:觀察應用異種脫細胞真皮基質(zhì)(ADM)修復膜(或聯(lián)合轉(zhuǎn)移肌瓣)修復82例頭頸腫瘤切除后組織缺損的近遠期效果。方法:對82例頭頸腫瘤切除后組織缺損應用異種ADM修復膜(或聯(lián)合轉(zhuǎn)移肌瓣)進行修復,其中65例直接以修復膜覆蓋黏膜缺損的創(chuàng)面,另17例將修復膜被覆于轉(zhuǎn)移的肌肉組織瓣表面。53例于術后2~4周加行放療。分別于術后1、3、6、12、18、24、30、36、48及60個月進行隨訪,電子喉鏡下觀察手術部位的修復情況以及患者的呼吸、吞咽、發(fā)聲等功能。結(jié)果:77例患者手術切口Ⅰ期愈合,另5例術后發(fā)生傷口感染,經(jīng)引流、局部換藥后Ⅱ期愈合;均順利拔除氣管套管及胃管,無局部瘢痕狹窄等發(fā)生。隨訪滿1、3及5年者分別有78、49和14例,其中加行術后放療者分別有53、32和12例。局部病變靜止者均未發(fā)現(xiàn)排斥、過敏等反應。結(jié)論:應用異種ADM修復膜(或聯(lián)合轉(zhuǎn)移肌瓣)修復頭頸腫瘤切除后組織缺損具有相對簡便易行、手術安全邊緣足夠、器官功能保存較好、喉狹窄發(fā)生率較低等優(yōu)點,近遠期修復效果均十分確切。
[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.
【作者單位】： 西安交通大學醫(yī)學院第一附屬醫(yī)院耳鼻咽喉頭頸外科;
【分類號】：R762

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本文編號：1769396