吻合血管的前臂皮瓣游离移植修复下咽癌术后缺损的疗效  

The efficacy of vascularized free radical forearm flap for hypopharyngeal carcinoma postoperative defect

作　　者：罗瑞华[1] 代立媛[1] 崔萌[1] 齐金星[1] 

机构地区：[1]河南省肿瘤医院头颈科,河南郑州450003

出　　处：《中国当代医药》2012年第19期24-25,共2页China Modern Medicine

基　　金：河南省2010年度医学科技攻关计划普通项目(201003127)

摘　　要：目的分析吻合血管的前臂皮瓣游离移植修复喉癌术后缺损的临床疗效。方法选择明确诊断的下咽癌患者16例,所有患者行下咽癌联合根治术加吻合血管的前臂皮瓣游离移植修复术后缺损,随访观察并分析手术疗效和喉功能恢复情况。结果术后15块组织皮瓣完全存活,1例部分坏死。13例受区伤口Ⅰ期愈合、3例出现局部并发症延期愈合,15例供区创面Ⅰ期愈合、1例因伤口裂开延期愈合。所有患者术后外观基本恢复正常,15例吞咽和发音功能均良好,可进行清楚语言交流,1例患者经2个月进食锻炼后回复吞咽功能。10例患者无瘤生存,2例死于肿瘤局部复发,4例患者死于咽淋巴环转移。结论吻合血管的前臂皮瓣游离移植是一种有效修复下咽癌术后缺损的方法,重建后的发音、吞咽功能恢复理想。Objective To analyze the efficacy of vascularized free radical forearm flap for hypopharyngeal carcinoma postoperative defect. Methods Sixteen patients with hypopharyngeal carcinoma were selected. The hypopharyngeal joint radical mastectomy and vascularized free radical forearm flap repaired postoperative defect were performed on all patients. The efficacy and function of throat were followed up. Results Fifteen free radial forearm flaps survived completely and 1 patial necrosis. The accept flap wound of 13 cases were phase I healing and 3 cases delayed healing. The supply flap wound of 15 cases were phase I healing and 1 cases delayed healing. The function of swallow and voice of 15 patients recovered from surgery and 1 patient swallow function recovered after 2 months. Ten patients without tumor recurrence were survival, 2 patients with local recurrence and 4 patients died of lymph node metastatic. Conclusions Vascularized free radical forearm flap is a useful treatment to repair hypopharyngeal carcinoma postoperative defect, and recovery of swallowing function and vocal function after reconstruction is good.

关 键 词：前臂皮瓣游离移植 修复 下咽癌 缺损 

分 类 号：R473.73[医药卫生—护理学]