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目的:探讨不同修复方法在头颈部恶性肿瘤术后缺损Ⅰ期修复与重建中的作用,评价其临床效果。方法:1989年1月至1998年12月,我们对258例头颈部恶性肿瘤患者的术后缺损进行了Ⅰ期修复与重建,患者年龄23～81岁,中位年龄51.3岁,男160例,女98例。缺损部位包括:头皮62例,颈部40例,口颊部39例,鼻部29例,唇颏部27例,颧颞部22例,下颌骨20例,舌及口底部12例,其它7例。修复方法:局部皮瓣修复75例;局部皮瓣加游离植皮53例;邻近组织瓣修复加游离植皮47例;肌皮瓣18例;肌皮瓣加局部皮瓣或游离植皮25例;游离组织瓣移植30例;游离组织瓣加邻近组织瓣修复3例;组织代用品7例。结果:全组258例病人,共采用276个皮瓣及组织代用品修复。手术成功224例,手术基本成功23例,手术失败11例。结论:头颈部肿瘤术后Ⅰ期修复与重建可最大限度地减少术后功能障碍和畸形,提高患者生存质量。
Objective: To investigate the role of different repair methods in repairing and reconstructing the defect of head and neck malignancies after operation, and to evaluate its clinical effects. METHODS: From January 1989 to December 1998, we performed a phase I repair and reconstruction of 258 patients with head and neck malignancies. The patients were aged from 23 to 81 years old, with a median age of 51.3 years and 160 males. 98 females. The defect sites included: 62 cases of scalp, 40 cases of neck, 39 cases of cheeks, 29 cases of nose, 27 cases of labrum, 22 cases of tendon, 20 cases of mandible, 12 cases of tongue and mouth bottom, and others 7 example. Repair methods: 75 cases of local flap repair; 53 cases of local skin flap plus free skin graft; 47 cases of free skin flaps repaired by adjacent tissue flaps; 18 cases of myocutaneous flaps; 25 cases of myocutaneous flaps plus partial flaps or free skin grafts; There were 30 cases of flap transplantation, 3 cases of free tissue flaps plus adjacent tissue flaps, and 7 cases of tissue substitutes. Results: A total of 258 patients were treated with 276 flaps and tissue substitutes. 224 cases were successfully performed. 23 cases were basically successful in the operation and 11 cases failed in the operation. Conclusion: The first-stage repair and reconstruction of head and neck cancer can minimize postoperative dysfunction and deformity and improve the quality of life of patients.