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目的探讨头颈部皮肤恶性肿瘤外科治疗方法和病损修复的疗效。方法对包括基底细胞癌12例和鳞状细胞癌4例的16例头颈部皮肤恶性肿瘤患者,采用Mohs显微外科手术(MMs)和标准切除术切除肿瘤,术后选择不同的修复方法,分别是直接缝合6例、邻近皮瓣法修复9例、耳郭复合组织瓣法修复1例。结果 16例术后随访1~6年,复发1例为基底细胞癌(鼻背部)患者,其于术后5个月局部复发,经再次手术扩大切除后采用邻近皮瓣修复,随访2年未再复发;随访患者均存活良好,外形及功能满意。结论头颈部皮肤恶性肿瘤的预后关键是早期诊断和治疗,结合肿瘤不同部位及大小采取不同手术方法,在彻底切除病变的基础上尽可能遵循功能和美观的原则行修复治疗。
Objective To investigate the surgical treatment of head and neck skin malignant tumors and the efficacy of lesion repair. Methods Sixteen patients with head and neck skin cancer, including 12 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma, were treated with Mohs microsurgery (MMs) and standard resection to remove the tumor. After operation, different repair methods were selected, They were directly sutured in 6 cases, adjacent flap repair in 9 cases, and auricle composite flap repair in 1 case. Results Sixteen patients were followed up for 1 to 6 years. One patient with recurrent BSC (nasal dorsum) had local recurrence 5 months after operation. Adjacent flaps were used for reoperation. The patients were followed up for 2 years Recurrence; follow-up patients were alive, shape and function satisfactory. Conclusion The key to the prognosis of head and neck malignant tumors is early diagnosis and treatment. Different surgical methods are used in combination with different parts and sizes of tumors to repair and treat as far as possible following the principle of function and aesthetics.