摘要
目的观察并评估下斜方肌肌皮瓣携带部分背阔肌修复头顶枕部肿瘤切除术后组织缺损的临床效果。方法回顾性分析2015年1月至2020年1月天津市职业病防治院(天津市工人医院)和天津医科大学第二医院收治的8例采用下斜方肌肌皮瓣携带部分背阔肌修复头顶枕部组织缺损患者的病例资料,其中男6例,女2例,年龄26~68岁。病变均为恶性肿瘤所致的颅骨缺损及硬脑膜外露。本组病例对斜方肌肌皮瓣切取进行了改进,利用下斜方肌肌皮瓣携带部分背阔肌修复上述缺损,即切取肌皮瓣时远端自背阔肌深层分离,组织瓣携带部分背阔肌,其大小视硬脑膜缺损大小而定。结果8例患者的创面面积为12 cm×8 cm~17 cm×15 cm,手术均顺利完成。术后7例肌皮瓣成活,伤口愈合良好;1例术后2 d组织瓣远端出现水泡和瘀斑,经换药10 d后痊愈。本组所有病例术后随访6个月,皮瓣均存活,术后背部供区少许瘢痕增生,复查肩关节活动均无明显异常。结论下斜方肌肌皮瓣携带部分背阔肌修复头顶枕部组织缺损可行,临床效果满意。
Objective To evaluate the functional outcomes of repairing parietal and occipital defect after surgery for cancer by lower trapezius myocutaneous flap with latissimus dorsi.Methods Retrospective analyses of eight patients were performed who underwent repairing parietal and occipital defects with dural exposure after surgeries for cancers from January 2015 to January 2020 in Tianjin Institute of Occupational Disease Control and Prevention(Tianjin Workers Hospital)and the Second Hospital of Tianjin Medical University,including 6 males and 2 females aged from 26 to 68 years old.The method for harvesting the lower trapezius myocutaneous flap was improved and thus the lower trapezius myocutaneous flaps with latissimus dorsi were used for repairing the parietal and occipital defects.The area of myocutaneous flap depended on the size of defect.Results The defects were repaired with the flaps with areas ranging from 12 cm×8 cm to 17 cm×15 cm.Seven flaps survived after surgery and the wounds were healed.Blisters and bruise were observed at the distal end of one flap 2 days after operation,which were cured with dressing change for 10 days.All cases were followed-up for six months,with normal functions of the shoulder joints,aside from mild hypertrophic scar in donor site on the back.Conclusion It is feasible to use the lower trapezius myocutaneous flap with latissimus dorsi to repair the parietal and occipital defect after surgery for cancer,and the clinical effect is satisfactory.
作者
罗征
宋维杰
李钢
Luo Zheng;Song Weijie;Li Gang(Department of Otorhinolaryngology Head and Neck Surgery,Tianjin Institute of Occupational Disease Control and Prevention(Tianjin Workers Hospital),Tianjin 300021,China;Department of Dermatology and Plastic Cosmetic,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2021年第6期648-651,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
外科皮瓣
斜方肌
背阔肌
头皮缺损
Surgical flaps
Trapezius muscle
Latissimus dorsi
Scalp defect
