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目的:研究应用改良C型异种脱细胞真皮基质(H-ADM)修复重建“<25 mm×25 mm仅侵及黏膜下或肌浅层”的小型舌鳞癌切除缺损的临床价值。方法:选择2008—2011年间按入选标准收治的应用C型H-ADM修复重建小型舌癌切除遗留的舌组织缺损64例,全部以C型H-ADM覆盖创面,以拉网打包严密固定,观察拆包当天,第1、2、7、14、28天的近期疗效和3、6、12个月中期缺损创面的上皮黏膜化情况。结果:本组病例均获得随访。拆包当天即出现缺损创面的愈合过程,作为愈合过程最重要的特征是H-ADM降解后遗留的类黏液状伪膜,在1周内达到高峰,以后随时间下降,在2个月时已完全消除,此时创面已为界限模糊、稍有萎缩、光滑平坦的组织覆盖。结论:H-ADM对小型舌癌切除后遗留的缺损创面有明显促进愈合作用,局部以凡士林外裹碘仿纱条加压包扎,具有一定益处。
OBJECTIVE: To study the clinical value of modified C-type acellular dermal matrix (H-ADM) in reconstruction and reconstruction of small tongue squamous cell carcinoma with “25 mm × 25 mm invaded submucosa or muscular superficial”. Methods: Sixty-four cases of tongue defects were resected and reconstructed with type C H-ADM from 2008 to 2011. All wounds were covered with C-type H-ADM. The immediate curative effect on the 1st, 2nd, 7th, 14th, and 28th days of unpacking and the mucosal epithelialization of wounds at 3, 6 and 12 months. Results: All patients were followed up. The healing process of the defect wound occurred on the day of unpacking. As the most important feature of the healing process, the mucoid pseudomembranous membrane remained after degradation of H-ADM, reached its peak within 1 week and then decreased with time. At 2 months Completely eliminated, this time the wound has blurred the boundaries, slightly reduced, smooth and flat tissue cover. CONCLUSION: H-ADM can significantly promote the healing of small wounds left after resection of small tongue cancer, and some of the wounds are packed with Vaseline gauze wrapped with Vaseline, which has certain benefits.