摘要：
目的 探讨局部皮瓣在鼻部皮肤肿瘤切除后创面修复中的效果.方法 2015年3月至2016年8月于新疆维吾尔自治区人民医院皮肤科纳入65例鼻部皮肤肿瘤患者,手术切除鼻部肿瘤,根据鼻缺损的部位、大小、形状以及周围皮肤情况等选择鼻唇沟皮瓣、改良菱形皮瓣、双叶皮瓣或额鼻皮瓣等修复皮肤软组织缺损.结果 65例患者中,基底细胞癌38例,色素痣20例,角化棘皮瘤5例,鳞状细胞癌2例.切除后缺损长径均未超过2.5 cm,32例用鼻唇沟皮瓣修复缺损,16例用改良菱形皮瓣,12例用双叶皮瓣,5例用额鼻皮瓣,术后皮瓣全部成活,未见鼻部明显变形,随访1年未见复发.结论 对于鼻部皮肤肿瘤切除后长径未超过2.5 cm的皮肤缺损,用鼻唇沟皮瓣、改良菱形皮瓣、双叶皮瓣、额鼻皮瓣等修复可以获得较满意的效果.%Objective To evaluate the effect of local flaps on repair of defects after surgical removal of nasal skin tumors.Methods A total of 65 patients with nasal skin tumors were enrolled from Department of Dermatology,People's Hospital of Xinjiang Uygur Autonomous Region between March 2015 and August 2016,and subjected to surgical removal of the nasal skin tumors.According to the location,size,shape and surrounding skin of the nasal defects,nasolabial fold flaps,modified rhomboid flaps,bilobed flaps or frontal nasal flaps were chosen to repair skin and soft tissue defects.Results Of the 65 patients with nasal skin tumors,38 had basal cell carcinoma,20 pigmented nevus,5 keratoacanthoma,and 2 had squamous cell carcinoma.The lengths of the defects after resection were all below 2.5 cm.Nasolabial fold flaps were used in 32 cases,modified rhomboid flaps in 16,bilobed flaps in 12,and frontal nasal flaps in 5.All the flaps survived after the surgery,and no obvious deformation of the nose was observed.No recurrence was observed during 1 year of follow-up.Conclusion For skin defects with the length ≤ 2.5 cm after resection of nasal skin tumors,nasolabial fold flaps,modified rhomboid flaps,bilobed flaps and frontal nasal flaps can be used to repair wounds,with satisfactory efficacy.
