背阔肌皮瓣应用体会.docVIP

背阔肌皮瓣应用体会 　　[摘要] 目的 对临床采用背阔肌皮瓣技术患者进行治疗过程中的相关应用体会进行总结。 方法 抽取2006年3月～2011年3月38例患有晚期乳腺癌并出现胸壁大面积损伤的临床确诊患者病例，将其分为A、B两组，平均每组19例。首先分别采用游离植皮技术和游离植皮与背阔肌皮瓣联合的方法对两组进行修复治疗。其次要给予所有的患者以放疗，一般在植皮术后8周后进行放疗，根据患者胸部受累情况选择胸部趋区域对其进行照射。 结果 B组患者的临床治疗效果明显优于A组患者；该组患者在治疗后出现局部复发现象的人数明显少于A组患者。 结论 在放疗后，采用背阔肌皮瓣与游离植皮技术联合的方法安全可靠。 　　[关键词] 背阔肌皮瓣；晚期乳腺癌；治疗；应用体会 　　[中图分类号] R737.5 [文献标识码] A [文章编号] 1674-4721（2012）02（b）-0064-02 　　 　　Application experience of latissimus dorsi myocutaneous flap 　　XIE Donggeng 　　Xiangdong Hospital Affiliated by Hunan Normal University, Liling 412200, China 　　[Abstract] Objective To summaries the application experience of treating patients with latissimus dorsi myocutaneous flap. Methods Thirty three clinical diagnosed patientswho suffered from advanced breast cancer and a wide area chest wall scathing from May 2006 to May 2011 in our hospital were picked out, and divided into group A and B. First, free skin-grafting and free skin-grafting technique combined with latissimus dorsi myocutaneous flap were separately used to the two groups. Second, radiotherapy was used to all the patients. Generally, the radiotherapy was taken 8 weeks after skin-grafting according to the affected condition of patients chest. Results The clinical treatment effect of group was obliviously superior to group B. After treatment, the patients underwent local recurrence of group B were apparently less than group A. Conclusion The combination of free skin-grafting technique and latissimus dorsi myocutaneous flap is safe and dependable which is used after radiotherapy. 　　[Key words] Latissimus dorsi myocutaneous flap; Advanced breast cancer; Treatment; Application experience 　　 　　一直以来，医学界广泛认为患有局部晚期乳腺癌（local advanced breast cancer，LABC）的患者不能够采用手术的方法进行治疗[1]，近年来，采用新辅助化疗技术对该??患者进行治疗，已经被越来越多的临床医生和广大患者所接受，在使患者的肿瘤降期之后，可以进行局部根治性手术对其进行治疗；但患者在接受肿瘤切除手术治疗后，会出现局部大面积软组织缺损的现象，如何采用整形科的相关治疗技术对其进行修复治疗是目前临床上一个亟待解决的问题[2]。为了对临床采用背阔肌皮瓣技术对患者进行治疗过程中的相关应用体会进行总结，为临床找到一种对该类患者进行修复治疗的有效方法，使该类患者的临床转归和预后更加理想，使患者在心理上对辅助化疗治疗技术