目的：总结并探讨表现为溃疡的小腿鳞状细胞癌的外科手术治疗方式及临床疗效。方法回顾性分析2012年1月至2014年1月间17例因小腿溃疡难以愈合，经病理检查确诊为鳞状细胞癌患者的临床资料，根据创面部位及情况，在将病灶扩大切除并确认切缘与基底部均为阴性的基础上，Ⅰ期或者Ⅱ期选择利用邻近皮瓣转移或游离皮片植皮修复创面。术后通过对创面愈合情况、鳞状细胞癌的治愈情况及功能活动等进行疗效综合评估。结果术后17例患者均获随访，时间6~15个月，平均9.5个月。患者创面愈合好，无复发情况，患肢功能活动恢复良好。结论小腿鳞状细胞癌在彻底切除的基础上，采取完善的术前准备，适宜的手术时机，合适的手术方式及精心的术后护理，临床疗效满意。%Objective To summarize and investigate the clinical effect and the surgical treatment of ulcer squamous cell carcinoma of the lower leg. Methods A retrospective analysis was performed on 17 cases of squamous cell carcinoma of the lower leg in January 2012 - January 2015. The cases without union due to leg ulcer were confirmed to be squamous cell carcinoma by pathological examination. According to the site and the wound, based on confirmed negative of the cutting edge and base after the lesions extended resection,the adjacent flap or free skin graft was used to repair the wound on one stage or two stage. Curative effect was comprehensively evaluated by the wound healing,the cure of squamous cell carcinoma,and the function after operation. Results All the 17 patients were followed up for 6 to 15 months with an average of 9.5 months. The wound healed well without recurrence and the functional activity of the affected limb recovered well. Conclusion Perfect preoperative preparation,appropriate timing of surgery,appropriate surgical approach and careful postoperative nursing should be taken for the patients with squamous cell carcinoma of the lower leg after radically resected procedure,the therapeutic effects are satisfactory.
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