摘要
目的探讨Mohs显微描记手术治疗头面部基底细胞癌、鳞状细胞癌及鲍温病等皮肤恶性肿瘤的疗效和预后,分析头面部皮肤恶性肿瘤的临床特点。方法该院收治的未见转移的面部皮肤恶性肿瘤患者411例,分为Mohs手术组256例,传统术中冷冻手术组130例,经验切除组25例,并对切取肿瘤创面采用邻近皮瓣、肌皮瓣及游离皮片或直接缝合方式修复。随访3~5年。结果 Mohs手术组248例手术切口Ⅰ期愈合,皮瓣或皮片全部成活,8例Ⅱ期愈合,2例复发(0.8%)。传统术中冷冻手术组125例手术切口Ⅰ期愈合,5例Ⅱ期愈合,7例复发(5.4%)。经验切除组25例均Ⅰ期愈合,4例复发(16%)。各组术后病理复检发现,肿瘤残余和临床复发率差异有统计学意义(P<0.01)。结论 Mohs手术可以在完整切除肿瘤的同时尽可能保留正常组织减少外观影响,是目前治疗头面部皮肤恶性肿瘤的首选方案。
Objective To investigate the effects and prognosis of Mohs surgery for treating craniofacial cutaneous malignant tumors,such as basal cell carcinoma(BCC),squamous cell carcinoma(SCC).Bowen's disease and actinic keratosis(AK)and analyze the clinical characteristics of craniofacial cutaneous malignant tumors.Methods Totally411cases of cutaneous malignant tumors without metastasis were enrolled,of which256cases were performed the Mohs microsurgery(group A),130cases were performed surgical operation with the traditional intraoperative frozen-section examination(group B),25cases were performed classic surgical operation(group C).Adjacent flap,myocutaneous flap,skin graft or direct suture was used to repair the wound.All were followed up for3to5years.Results In group A,248cases wereⅠhealing with skin flaps and skin grafts all survived;8cases wereⅡhealing,2cases recurred(0.8%).In group B,125cases wereⅠhealing,5cases wereⅡhealing,7cases recurred(5.4%).In group C,all cases wereⅠhealing,4cases recurred(16%).The recurrence rate was statistically differentanlong thro groups(P<0.05).Conclusions Mohsmicrosurgery is the first choice to treat craniofacial cutaneous malignant tumors,which can resect tumor completely,at the same time reserve the normal skin tissues to the greatest extent and reduce the excessive damage to patients'appearance by operation.
作者
杨镓宁
吴冬梅
戴耕武
潘宁
Jia-ning Yang;Dong-mei Wu;Geng-wu Dai;Ning Pan(Department of Dermatological Surgery, Sichuan Provincial People's Hospital,Chengdu, Sichuan 610031, China)
出处
《中国现代医学杂志》
CAS
北大核心
2017年第18期70-73,共4页
China Journal of Modern Medicine
基金
四川省卫生和计划生育委员会科研课题(No:140084)
关键词
Mohs手术
皮肤恶性肿瘤
头面部
治疗
Mohs microsurgery
cutaneous malignant tumor
craniofacial
treatment
