CAJ | 학술논문

目的探讨穿支皮瓣在修复外阴癌广泛性切除术后皮肤软组织缺损中的临床应用价值.方法回顾性分析2010年2月-2014年2月北京大学第一医院收治的12例外阴癌患者的临床病理资料,其中Ⅱ期5例、Ⅲa期3例、Ⅲb期4例,鳞癌10例、Paget病1例、恶性黑色素瘤1例.12例患者均行外阴广泛性切除术,术中采用以阴唇后动脉穿支、闭孔动脉前支穿支为蒂的穿支皮瓣修复外阴皮肤缺损创面,行外阴重建术.结果 12例外阴癌患者中,皮瓣全部成活,其中11例切口Ⅰ期愈合,1例切口感染经换药后愈合;术后对患者进行了2～12个月的随访,其外阴形态丰满,无明显臃肿,阴道口无狭窄,瘢痕无明显挛缩.结论应用穿支皮瓣修复外阴癌广泛性切除术后的皮肤软组织缺损,行外阴重建术,可以使外阴癌患者在广泛性切除术后获得很好的外形重建及功能恢复,具有很高的临床应用价值.
목적 탐토천지피판재수복외음암엄범성절제술후피부연조직결손중적림상응용개치.방법 회고성분석2010년2월-2014년2월북경대학제일의원수치적12예외음암환자적림상병리자료,기중Ⅱ기5례、Ⅲa기3례、Ⅲb기4례,린암10례、Paget병1례、악성흑색소류1례.12례환자균행외음엄범성절제술,술중채용이음진후동맥천지、폐공동맥전지천지위체적천지피판수복외음피부결손창면,행외음중건술.결과 12예외음암환자중,피판전부성활,기중11례절구Ⅰ기유합,1례절구감염경환약후유합;술후대환자진행료2～12개월적수방,기외음형태봉만,무명현옹종,음도구무협착,반흔무명현련축.결론 응용천지피판수복외음암엄범성절제술후적피부연조직결손,행외음중건술,가이사외음암환자재엄범성절제술후획득흔호적외형중건급공능회복,구유흔고적림상응용개치.
Objective To evaluate the clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma.Methods Retrospectively,twelve cases of vulva carcinoma were treated by radical extensive excision,and the defects were repaired with perforator flap.Results All the flaps were survived and healed with first intention except one infection.The wound infection patient was treated with change of the dressing and antibiotics.The reconstructed vulvae were plump and elastic.It appeared like the normal vulvae and there was no contraction of the vagina.Conclusions Vulvar reconstruction with the perforator flap after the radical vulvectomy could make the patients recover easily,which produces almost normal appearance and function of the vulvae,reduces the time of wound healing,the patient could get the next therapy more quickly and the quality of life improving.It has wide clinical application value.