带蒂岛状胸大肌肌皮瓣在头颈恶性肿瘤术后缺损修复重建中的应用研究  

The clinical application research on the island pedicled pectoralis major muscle flap in repairing of the tissue defects after the operation of head and neck malignant tumors

作　　者：李真华[1] 葛家华[1] 吴剑[1] 叶果[1] 张玉莲[1] 黄闯[1] 周晓红[1] 

机构地区：[1]重庆市肿瘤研究所头颈外科,400030

出　　处：《重庆医学》2013年第35期4279-4280,共2页Chongqing medicine

摘　　要：目的探讨带蒂岛状胸大肌肌皮瓣对头颈部恶性肿瘤切除术后大面积软组织缺损一期修复重建中的疗效。方法 2011年4月至2012年9月该院对27例头颈部恶性肿瘤术后大面积软组织缺损采用带蒂岛状胸大肌肌皮瓣一期修复重建,其中舌癌11例、腮腺癌2例、牙龈癌3例、口咽癌2例、口底癌9例。结果 27例患者安全度过围术期,27例岛状胸大肌肌皮瓣均成活,患者在外观和功能上均获得满意的临床疗效。术后发生颈部血肿1例,及时探查清除血肿,彻底止血后消除;1例因皮瓣表皮坏死清除坏死皮肤,肌瓣成活,表面肉芽修复,不影响治疗效果。结论岛状胸大肌肌皮瓣在头颈部恶性肿瘤术后大面积软组织缺损重建、修复有其独特优越性,其组织量丰富,胸肩峰动脉解剖位置恒定,手术易操作,血供丰富,抗感染能力强,成活率高。术中操作精细是岛状胸大肌肌皮瓣成活的关键。Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors.Methods From April 2011 to September 2012,27patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated,including 11 cases of tongue cancer defect,2 cases of parotid gland defect,3 cases of gum cancer defect,2 cases of oropharyngeal cancer defect,9 cases of floor of the mouth cancer defect.Results 27 patients were safety in perioperative,27 cases of island pectoralis major muscle flap survived,patients were satisfied with both the appearance and function.There was postoperative neck hematoma in 1 patient,it was eliminated through timely remove the hematoma and hemostasis completely; There was 1 case of removing the epidermal necrolysis skin as flap necrosis,while it was acceptable efficacy as the muscle flap survival and surface granulation repaired.Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation,such as abundant of tissue,a constant arterial anatomy of thoracoacromial,easy to operate,rich blood supply,strong resistance to infection,high survival rate and so on.A fine surgery operation is the key of island pectoralis major muscle flap survival.

关 键 词：头颈部肿瘤 外科 皮瓣 胸肌 修复外科手术 

分 类 号：R739.91[医药卫生—肿瘤]