带蒂大网膜移植术治疗恶性肿瘤放射性胸部溃疡并胸骨骨髓炎的临床疗效分析  

Clinical analysis on pedicle great omentum grafting for radiation-induced chest ulcer and sternal osteomyelitis of malignant tumor

作　　者：李佳[1] 李永锋[1] 黄伯湘[1] 陈记财[1] 陈晓伟[1] 赵青武 林宇[1] LI Jia;LI Yong-feng;HUANG Bo-xiang(Department of Thoracic and Cardiovascular Surgery,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院心胸外科,510120

出　　处：《中国实用医药》2024年第1期50-52,共3页China Practical Medicine

摘　　要：目的探讨带蒂大网膜移植术治疗恶性肿瘤放射治疗(放疗)后引发的胸部溃疡并胸骨骨髓炎的临床疗效。方法回顾性分析4例恶性肿瘤放射性胸部溃疡并胸骨骨髓炎患者的临床资料,均行带蒂大网膜移植手术治疗,观察治疗效果。结果4例患者均顺利实施手术治疗,手术时间85~150 min,出血量200~700 ml,住院天数22~99 d。1例患者术后溃疡面积明显缩小,仅残留针状窦道,出院后门诊换药6个月后治愈;其余患者均顺利治愈出院,无二次手术。1例患者术后1年因肺癌肝转移死亡,其余3例随访至今胸骨骨髓炎无复发。结论对于恶性肿瘤放射性胸部溃疡并胸骨骨髓炎患者,带蒂大网膜移植术是一种安全有效的手术方式。Objective To explore the clinical effects of pedicle great omentum grafting for radiation-induced chest ulcer and sternal osteomyelitis of malignant tumor.Methods A total of 4 cases with malignant tumor suffering from radiation-induced chest ulcer and sternal osteomyelitis were analyzed retrospectively,and all were treated by pedicle great omentum grafting.The therapeutic effect was observed.Results All 4 patients underwent pedicle great omentum grafting successfully.The operative duration was 85-150 min,the blood loss was 200-700 ml,and the days of hospitalization was 22-99 d.Except for decreased ulcer and residual fistula in 1 patient,and the patient was cured after 6 months of outpatient dressing change after discharge.All the other patients were successfully cured and discharged from hospital without a second surgery.1 case died of lung cancer with liver metastasis,while there was no recurrence in 3 cases to date.Conclusion Pedicle great omentum grafting is a safe and effective surgical option for radiation-induced chest ulcer and sternal osteomyelitis of malignant tumor.

关 键 词：胸骨骨髓炎 恶性肿瘤 胸部溃疡 带蒂大网膜移植术 放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R681.2[医药卫生—临床医学]