严重放射性溃疡的修复  

REPAIR OF SEVERE RADIATION INDUCED ULCER

作　　者：沈余明[1] 沈祖尧[1] 王乃佐[1] 马春旭[1] 桑慧华 宓惠茹[1] 

机构地区：[1]北京积水潭医院烧伤科,北京100035

出　　处：《中国修复重建外科杂志》2000年第4期208-210,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　探讨严重放射性溃疡的修复方法及其临床效果。方法　自 1988年 8月～ 1998年 12月 ,采用肌瓣或肌皮瓣移位修复严重放射性溃疡 12例 ,其中胸大肌肌瓣 1例 ,三叶状横形腹直肌肌皮瓣 3例 ,背阔肌肌皮瓣 2例 ,阔筋膜张肌肌皮瓣 1例 ,纵形腹直肌肌皮瓣与阔筋膜张肌肌皮瓣 1例 ,腓肠肌肌瓣 1例 ,臀大肌肌皮瓣1例 ,下肢巨大剔骨肌皮瓣 1例 ,上肢剔骨肌皮瓣 1例。结果　肌瓣、肌皮瓣全部成活 ,伤口 期愈合 9例 , 期愈合3例。2例肢体剔骨肌皮瓣不仅修复了巨大溃疡而且挽救了患者生命。3例在修复溃疡的同时行乳房重建 ,获得满意效果。结论　肌瓣、肌皮瓣血供丰富 ,组织量大 ,充填效果好 ,外观良好 。Objective\ \ To explore a method to repair severe radiation induced ulcer and evaluate its clinical effects.Methods\ \ From August 1988 to December 1998,12 cases of severe radiation induced ulcer were treated by muscular or musculocutaneous flap transfer,which included 1 case of pectoralis major muscular flap,3 cases of three lobed transverse rectus abdominis musculocutaneous flap,2 cases of latissimus dorsi musculocutaneous flap,1 case of tensor fascia lata musculocutaneous flap, 1 case of longitudinal rectus abdominis musculocutaneous and tensor fascia lata musculocutaneous flap,1 case of gastrocnemius muscular flap, 1 case of gluteus major musculocutaneous flap,huge filleted musculocutaneous flap from lower limbs in 1 case and from upper limbs in 1 cases. Results\ All the flaps survived.Primary healing occured in 9 cases and secondary healing in 3 cases.The extensive multiple ulcers in 2 cases were repaired with filleted limb musculocutanous flap,and patients were saved.And in other 3 cases,the chest wall defect as the result of radionecrosis were repaired with simutaneous breast reconstruction.Conclusion\ Muscular or musculocutaneous flaps have abundant blood supply,they are ideal tissue to fill the cavity and repair the defect,especially in repairing severe radiation induced ulcers.

关 键 词：放射性溃疡 肌瓣 肌皮瓣 修复 

分 类 号：R622[医药卫生—整形外科]