胸大肌岛状肌皮瓣一期修复头颈肿瘤术后组织缺损的临床应用

摘要

Objective To study clinical application of pectoralis major myocutaneous island flap for reconstruction of defects in head and neck tumors. Methods This paper is to summarize retrospectively the clinical experience of 39 cases since 1988.In these cases, the defects after excision of head and neck carcinoma were immediately repaired. Those were repaired including half tongue body and floor of mouth, partial laryngopharynx and cervical esophagus, pharyngeal fistula on anterior neck skin, parotid area, laryngotracheal stoma and manubrium area. Results Of the 39 cases, myocutaneous island flap fully survived in 36 and there were 3cases of partial necrosis of skin, but the musclar layer was still viable. Follow-up of these patients revealed that survival rates were 69%(27/39) for three years and 26%(10/39) for five years. Conclusion It has the advantage of repairing and reconstructing in a partial defect in head and neck tumors, because pectoralis major myocutaneous island flap is rich blood supply and high success rate.%目的总结胸大肌岛状肌皮瓣在头颈肿瘤手术一期修复中的临床应用。方法39例头颈肿瘤手术接受胸大肌岛状肌皮瓣一期修复与重建；修复区域有半侧舌体及口底，部分喉咽及食道，颈前区咽瘘，腮腺区皮肤、喉造口及胸骨柄等。结果39例中36例肌皮瓣全部成活(92%)，3例皮岛皮肤部分坏死(8%)，皮岛周围及深部感染9例(23%)，但肌层成活，通过经放置引流、换药最后自愈。临床随访3年生存率69%(27/39)，5年生存率26%(10/39)。结论胸大肌岛状肌皮瓣血运丰富，成功率高，在一期修复与重建头颈肿瘤局部缺损中有其优势。