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目的 :探讨鼻部皮肤癌治疗的方法及缺损的修复手段。方法 :回顾性分析 3 6例鼻部皮肤癌临床资料 ,全部采用手术根治性切除鼻部皮肤癌加液氮冷冻的方法治疗 ,缺损用不同方法修复 ,其中直接缝合 5例 ,鼻唇沟皮瓣 2 0例 ,全厚皮片 7例 ,中厚皮片 3例及额部带蒂皮瓣 1例。结果 :采用直接缝合、中厚皮片及额部带蒂皮瓣修复的全部存活 ,采用鼻唇沟皮瓣、全厚皮片的各有 1例皮瓣部分坏死。 3例术后局部复发 ,其余病例随访 3年以上无复发。结论 :手术根治性切除鼻部皮肤癌加液氮冷冻的治疗方法值得推广。对于切除肿瘤的安全边界 ,基底细胞癌可适当保守些 ,鳞状细胞癌切除范围应更大一些。缺损可根据不同情况选择用直接缝合、鼻唇沟皮瓣、全厚皮片、中厚皮片及额部带蒂皮瓣等方法修复 ,只要掌握好适应证 ,均能获得满意效果
Objective: To explore the treatment of nasal skin cancer and repair methods of defect. Methods: The clinical data of 36 cases of nasal skin cancer were retrospectively analyzed. All cases were treated by radical resection of nasal skin cancer with liquid nitrogen freezing method. The defects were repaired by different methods, of which 5 cases were directly sutured, the nasolabial fold flap 20 cases, 7 cases of full thickness skin, 3 cases of thick skin and forehead pedicle flap in 1 case. Results: All the patients survived with direct suture, medium-thickness skin flap and frontal pedicle flap. One flank flap was partially necrotic with nasolabial fold flap and full-thickness skin flap respectively. 3 cases of local recurrence, the remaining cases were followed up for more than 3 years without recurrence. Conclusion: The surgical treatment of nasal skin cancer with liquid nitrogen freezing and radical resection is worth promoting. For removal of tumor safety margin, basal cell carcinoma may be conservative, squamous cell carcinoma resection range should be larger. Defect can be selected according to different situations with direct suture, nasolabial fold flap, full-thickness leather, thick skin and forehead pedicle flap and other methods to repair, as long as the indications, can be satisfied with the results