大范围下唇癌术式探讨才越.docVIP

大范围下唇癌术式探讨才越 　　【摘要】 目的：探讨导致大范围下唇缺损的唇癌的合理术式。方法：选择2003年3月-2013年3月本科收治的40例下唇癌患者作为研究对象，根据选择的修复方式的不同分为两组（Ⅰ、Ⅱ组），再根据选择的颈清扫术式分为两组（A、B组），比较各组术后情况。结果：Ⅰ、Ⅱ组术后口裂缩小及皮瓣坏死情况比较差异均无统计学意义（P0.05）。A组淋巴结复发率高于B组，比较差异有统计学意义（P0.05）。结论：改进修复下唇缺损的术式可避免二次手术创伤，肩胛舌骨上颈淋巴清扫能够更加确保肿瘤的根治，两者联合是目前最合理的术式。 　　【关键词】 下唇癌； 缺损； 修复重建； 颈清扫； 术式 　　Study on the Operation Method of Large Scale Lower Lip Carcinoma/CAI Yue，TAN Xue-xin，TONG Shuang，et al.//Medical Innovation of China，2016，13（08）：038-042 　　【Abstract】 Objective：To find out the reasonable operation method of lip carcinoma leading to the large scale defect of the lower lip.Method：40 cases of lower lip carcinoma patients who were in our department from March 2003 to March 2013 were selected as the research objects.They were divided into two groups（group Ⅰ and group Ⅱ） according to the repair method and then were divided into two groups（group A and group B） according to the neck dissection method.The postoperative situation of different groups were compared.Result：The differences in the reduction of the mouth crack and the necrosis of the flap between group Ⅰ and group Ⅱ were not statistically significant（P0.05）.The lymph node recurrence rate of group A was higher than that of group B，the difference was statistically significant（P0.05）.Conclusion：The modified operation method of repairing the lower lip defect can avoid the second surgical trauma.The supraomohyoid neck dissection method can more ensure the radical cure of tumors.The combination of the two methods is the most reasonable operation method. 　　【Key words】 Lower lip carcinoma； Coloboma； Reconstruction； Neck dissection； Operation method 　　First-author’s address：The Central Hospital of Huludao City，Huludao 125001，China 　　doi：10.3969/j.issn.1674-4985.2016.08.011 　　唇癌是发生于唇红缘黏膜的癌。鳞状细胞癌多见，腺癌较为少见。早期唇癌多表现为疱疹状结痂的肿块，有时也可表现为局部的黏膜增厚，之后会出现火山口状溃疡或菜花状肿块。唇癌多发生于下唇，易向颏下淋巴结及下颌下淋巴结发生转移，位于中线处的下唇癌也可发生双侧转移[1]。唇癌因较易发现，因而早期患者多已就诊并行相应治疗，但因治疗方法选择上的不当，临床上仍常见肿物生长较大以致侵及大部下唇者，并常有发生淋巴结转移者。对于此类患者手术无疑是最有效的治疗方式。如何选择一种合理的手术方式