三种方法修复唇癌术后缺损临床观察.doc

三种方法修复唇癌术后缺损临床观察[摘要]目的：探讨Abbe瓣、Estlander瓣和Bernard瓣修复唇癌术后缺损的效果。方法：对行Abbe瓣、Estlander瓣和Bernard瓣修复唇缺损的14例唇癌患者进行病例资料回顾性研究，对3种修复方法的效果进行评价。结果：随访期间，无局部复发及区域淋巴结转移。随时间的推移，功能及美观评分越来越高（功能及外形效果越来越好）。术后6个月，总体形态功能和自我评价的结果均较为满意。结论：Abbe瓣、Estlander瓣及Bernard瓣修复唇部缺损各有优点，需根据缺损大小、位置、患者需求选择，可达到满意效果。 [关键词]唇癌；缺损；修复 [中图分类号]R782 [文献标识码]A [文章编号]1008-6455（2012）05-0740-03 Clinical effect comparison of three methods for repairing lip defects after cancer resection LEI Ming-hui,ZHOU Shu-fang (1.Department of Stomatology,The Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China;2.Department of Stomatology,Xianyou County Hospital;3.Department of Stomatology,Dingbian County Chinese Medicine Hospital) Abstract: Objective Talk over the clinical effect in the reconstruction of lip defects after ablative surgery by using Abbe flap,Bernard flap and Estlander flap. Methods We report our experience with 14 patients who underwentAbbe flap,Bernard flap or Estlander flap reconstructions,and evaluated the clinical effects. Results No local relapse or lymph node metastasis was observed during 5 years follow-up.6 months after operation,the results provide for a good functionality of the lip and a satisfactory aesthetic aspect. Conclusion To the reconstructive of lip defects,Abbe flap,Bernard flap and Estlander flap havetheir own advantages.For achieve satisfactory results,they should be carefully selected according to the defect size andlocation,and the requirement of each patient. Key words:lip Carcinoma;defect;reconstruction 在头颈部恶性肿瘤当中，唇癌的发病率仅次于皮肤癌[1]。紫外线照射及烟草刺激为其常见危险因素。目前临床首选手术治疗，术后缺损较大时，多以局部皮瓣修复。目前已有多种修复方式可供选择。基本原则是在保证手术安全边界的基础上，尽可能地保存唇组织，最大程度恢复唇部功能及外形。手术缺损大小、位置、患者需求是制定修复方案的重要考量因素。近年来随着社会的进步，唇癌术后的修复效果逐渐成为医患双方关注的焦点。笔者在我院行Abbe瓣、Estlander瓣和Bernard瓣修复唇癌术后缺损的14例患者进行病例资料回顾性研究，讨论以上3种修复方法各自的适应证及其修复效果。 1 资料和方法 1.1临床资料：选取2002～2007年我院颌面外科手术治疗的唇癌患者14例（男8例，女6例），年龄43～68岁，平均（59.0±5.3）岁。病变发生于下唇者10例，上唇者4例。 1.2手术方法：所有病例均在肿瘤边缘扩大0.5～1.0cm“U”形切除，并一期修复。修复方法根据缺损