發(fā)布時(shí)間：2018-03-02 10:49

  本文關(guān)鍵詞： 原發(fā)灶對(duì)側(cè)頦下島狀肌皮瓣 口腔鱗狀細(xì)胞癌 組織缺損 修復(fù) 可行性　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討原發(fā)灶對(duì)側(cè)頦下島狀肌皮瓣應(yīng)用于口腔鱗狀細(xì)胞癌(oral squamous cell carcinomas OSCC)術(shù)后組織缺損修復(fù)的可行性,以期增加臨床工作者的選擇。方法:河北醫(yī)科大學(xué)第四醫(yī)院口腔科2013年11月-2016年1月之間收治的14例患者,12例患者為舌部腫物,2例患者為上牙齦腫物,術(shù)前經(jīng)病理證實(shí)為鱗狀細(xì)胞癌。年齡45-71歲。頜頸CT/MRI顯示原發(fā)灶同側(cè)有可疑轉(zhuǎn)移淋巴結(jié)組織,而對(duì)側(cè)沒有。均采用原發(fā)灶對(duì)側(cè)頦下島狀肌皮瓣修復(fù)術(shù)后組織缺損。通過隨訪觀察,分析皮瓣的成活率、修復(fù)效果、術(shù)后并發(fā)癥及腫瘤的復(fù)發(fā)和轉(zhuǎn)移情況,判斷原發(fā)灶對(duì)側(cè)頦下島狀肌皮瓣的適應(yīng)癥,指導(dǎo)臨床應(yīng)用。結(jié)果:14例患者中出現(xiàn)皮瓣壞死現(xiàn)象0例,皮瓣成活率為100%。術(shù)后出現(xiàn)頸部血腫繼而并發(fā)創(chuàng)腔感染1例。由面神經(jīng)下頜緣支損傷產(chǎn)生的相應(yīng)側(cè)口角下垂癥狀0例;下唇外翻及貓耳畸形0例。隨訪時(shí)間失訪1例,死亡1例。局部復(fù)發(fā)及頸部轉(zhuǎn)移0例。結(jié)論:原發(fā)灶對(duì)側(cè)頦下島狀肌皮瓣屬于頦下島狀肌皮瓣的一種,是一種可靠的、切取相對(duì)簡(jiǎn)單的、修復(fù)效果較好的、成活率較高的且術(shù)后并發(fā)癥少的皮瓣;能夠用于原發(fā)灶同側(cè)有可疑淋巴結(jié)轉(zhuǎn)移患者;如果術(shù)前檢查高度懷疑對(duì)側(cè)有可疑淋巴結(jié)轉(zhuǎn)移的患者,應(yīng)慎用。
[Abstract]:Objective: to investigate the feasibility of using the contralateral submental island myocutaneous flap to repair the tissue defect after oral squamous cell carcinomas OSCC. Methods: from November 2013 to January 2016, 14 patients were admitted to the Department of Stomatology, 4th Hospital of Hebei Medical University. 12 patients with tongue tumor and 2 patients with upper gingival mass, were selected from the Department of Stomatology of 4th Hospital of Hebei Medical University from November 2013 to January 2016. Squamous cell carcinoma was proved by pathology before operation. The age was 45-71 years old. CT/MRI of maxillary neck showed suspected metastatic lymph node tissue on the ipsilateral side of the primary lesion, but not on the other side. All patients were treated with the primary contralateral submental island myocutaneous flap to repair the postoperative tissue defect. The survival rate, repair effect, postoperative complications and tumor recurrence and metastasis of the flap were analyzed, and the indications of the primary locus contralateral submental island myocutaneous flap were determined to guide clinical application. The survival rate of the flap was 100. There was 1 case of cervical hematoma and then complicated with wound cavity infection. There were 0 cases of drooping symptoms of the corresponding side of mouth angle caused by the injury of the mandibular marginal branch of the facial nerve, 0 cases of lower lip valgus and cat's ear malformation. One case died. Local recurrence and cervical metastasis were found in 0 cases. Conclusion: the primary contralateral submental island myocutaneous flap is a kind of submental island myocutaneous flap. The flap with high survival rate and less postoperative complications can be used in patients with ipsilateral suspected lymph node metastasis.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R739.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉漢前;俞輝明;劉家武;房進(jìn);毛弛;;頦下島狀皮瓣聯(lián)合口腔修復(fù)膜重建腭洞穿型缺損患者術(shù)后語音功能評(píng)價(jià)[J];山東醫(yī)藥;2015年19期

2 蘇華;洪秀琴;陶曉梅;;舌癌聯(lián)合根治及同期頦下動(dòng)脈島狀瓣修復(fù)術(shù)的護(hù)理[J];護(hù)士進(jìn)修雜志;2015年01期

3 林勇;毛馳;;頦下島狀皮瓣同期修復(fù)口腔癌術(shù)后缺損的臨床應(yīng)用[J];國(guó)際口腔醫(yī)學(xué)雜志;2014年06期

4 劉漢前;俞輝明;毛弛;;頦下島狀皮瓣修復(fù)口腔癌術(shù)后軟組織缺損的療效觀察[J];中華耳鼻咽喉頭頸外科雜志;2014年09期

5 林璐;蘇彤;游鏡民;錢韻梅;;口腔癌對(duì)側(cè)頸淋巴結(jié)轉(zhuǎn)移的高危因素分析[J];臨床口腔醫(yī)學(xué)雜志;2014年04期

6 劉漢前;俞輝明;劉家武;房進(jìn);;頦下島狀肌皮瓣修復(fù)口腔鱗癌術(shù)后頰黏膜缺損效果觀察[J];山東醫(yī)藥;2013年34期

7 習(xí)偉宏;邵益森;曹鐘義;張絢;嚴(yán)俊峰;;cN0期舌癌頦下島狀肌皮瓣修復(fù)術(shù)后頸淋巴結(jié)轉(zhuǎn)移的相關(guān)因素[J];江蘇醫(yī)藥;2013年08期

8 章文博;彭歆;;口腔上頜鱗狀細(xì)胞癌頸淋巴轉(zhuǎn)移的研究進(jìn)展[J];中華耳鼻咽喉頭頸外科雜志;2013年04期

9 黃漢民;白植寶;黃磊;;頦下島狀肌皮瓣修復(fù)頰癌術(shù)后組織缺損的臨床[J];現(xiàn)代醫(yī)院;2011年04期

10 林松柏;曾融生;;不同皮瓣修復(fù)口腔癌術(shù)后缺損的效果比較[J];中華口腔醫(yī)學(xué)研究雜志(電子版);2010年06期

相關(guān)碩士學(xué)位論文 前1條

1 李文強(qiáng);口腔鱗狀細(xì)胞癌對(duì)側(cè)頸部淋巴轉(zhuǎn)移相關(guān)因素研究[D];中南大學(xué);2013年

，

本文編號(hào)：1556209