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头颈、上胸部皮肤黑色素瘤占所有黑色素瘤的30％～40％,这一区域的黑色素瘤有早期转移之趋势,故提倡对选择性病人做预防性淋巴清扫术。过去,清扫区域是根据临床判断和Sappey、Haagansen等的解剖学研究来选择的,但目前多数人的经验认为,这样做很不精确。本文论述了作者采用淋巴闪烁照像的方法指导原发头颈、上胸部黑色素瘤手术治疗的初步经验。本文资料为美国密执安大学医学中心1980年1月至1985年2月57例皮肤黑色素瘤经淋巴闪烁照像指导手术的资料,选其中肿瘤位于头颈、锁骨以上和肩胛区以上者24例作为研究对象。其中男性18例,女性6例。平均年龄52.3岁(24～84岁)。5例肿瘤位于头部,2例位于头皮,2例位于下颌,1例位于眼睑,4例位于
The melanoma of the head and neck and upper chest occupies 30% to 40% of all melanomas. The melanoma in this area has a tendency of early metastasis. Therefore, selective lymphatic dissection is recommended for selective patients. In the past, the sweeping area was selected based on clinical judgments and anatomical studies such as Sappey, Haagansen, etc. However, most people now experience that this is inaccurate. This article discusses the author’s initial experience in the use of lymphoscintigraphy to guide the surgical treatment of primary head and neck upper melanoma. The data of this article are the data of 57 cases of cutaneous melanoma from lymphatic scintigraphy guided surgery performed from January 1980 to February 1985 in the University of Michigan Medical Center. Among them, 24 cases with tumor located at the head and neck, above the clavicle and scapular region were selected as Research object. There were 18 males and 6 females. The average age is 52.3 years (24-84 years old). Five tumors were located in the head, two in the scalp, two in the lower jaw, one in the orbit, and four in the