乳癌放疗后放射性溃疡的治疗  

The complications of radiotherapy for breast cancer and the treatment for radiation ulcer

作　　者：李叶扬[1] 梁岷[1] 汪锦伦[1] 矫立仁[1] 黄峻[1] 

机构地区：[1]暨南大学医学院附属广州市红十字会医院烧伤整形科,广州510220

出　　处：《中华整形外科杂志》2004年第1期13-15,共3页Chinese Journal of Plastic Surgery

摘　　要：目的　探讨乳癌放射性治疗 (下简称放疗 )后放射性溃疡的治疗方法 ,阐述放疗后臂丛神经损伤的广泛性和严重性。方法　 1999年以来分别应用腹直肌肌皮瓣转移、皮肤软组织扩张、局部皮瓣转移和局部延迟皮瓣转移等方法修复乳癌放疗后放射性溃疡 16例 ,并常规行肌电图检查了解臂丛神经损伤的情况。结果　除 1例患者因创口感染而皮瓣部分坏死外 ,其余皮瓣成活良好 ,创面修复满意 ;10例行肌电图检查的患者中 ,有 7例合并有臂丛神经损伤。结论　乳癌放疗后引起的放射性溃疡常伴有臂丛神经损伤 ,这些损伤呈慢性、进行性和不可逆性改变 ;应用血运良好的皮瓣可有效地修复溃疡创面。Objective To explore the effective treatment for chronic ulcer following radiotherapy for breast cancer and reveal the universality and severity of radiation-induced brachial plexus neuropathy. Methods The TRAM flap, the local expanded flap or the delayed skin flap were applied to repair the ulcer wounds in 16 patients. Electromyogram examinations were used to evaluate the radiation lesions of the brachial plexus. Results All the flaps survived successfully with satisfactory results except one, which sustained partial necrosis due to infection. Ten patients underwent regular electromyogram examinations, seven of them were found to have radiation-induced brachial plexus neuropathy. Conclusions Radiation ulcer following radiotherapy for breast cancer is often concomitant with brachial plexus neuropathy. These injuries presented a chronically progressive and irreversible course. Application of the flaps that have adequate blood supply can reconstruct the wounds effectively.

关 键 词：放射性溃疡 乳癌 放疗后 治疗 臂丛神经损伤 肌电图检查 皮瓣 简称 创面修复 

分 类 号：R737.9[医药卫生—肿瘤] R473.6[医药卫生—临床医学]