摘要
目的探讨胸壁肿瘤切除后胸壁重建的方法。方法从１９８６－１９９８年对２９例胸壁肿瘤切除后病人采用多种术式进行了胸壁重建，骨性胸壁的修复包括采用自体组织（阔筋膜、肌瓣、大网膜）及人工替代物（金属支架、钛合金、Ｄａｃｒｏｎ、及Ｄａｃｒｏｎ＋骨水泥＋Ｄａｃｒｏｎ三文治式复合体）。皮肤软组织层的修复主要用岛状背阔肌皮瓣及乳房瓣。结果无手术死亡及局部复发，无严重并发症，恶性肿瘤术后５年生存率为５２％。结论骨性胸壁缺损６ｃｍ×６ｃｍ以上需行胸壁重建，一般可用自体组织，必要时加用金属支架，大面积缺损（１０ｃｍ×１０ｃｍ以上）以三文治式修复法为理想，皮肤软组织缺损的修复可选用岛状背阔肌皮瓣及乳房劈裂瓣。
Objective To study the operating procedure and repairing materials of chest-wall reconstruction.Method From 1986 to 1998,29 patients underwent chest-wall resection using several kinds of operating procedure and materials to reconstruct the chest-wall defects.The materials to repair the bony chest-wall include autografts(tensor fascial plate,muscle flap,great omentum flap),and artificial materials(metal framework,titanium plate,dacron,and prothesis of sandwich type).Results There were no operating death,local failure and serious complication.The 5 year survival rate was 52%.Conclusion It is suggested that the area of bony chestwall defects under 10×10cm can use autograft.But while the area of defects is over 10×10cm,the better material is prothesis of sandwich type.The island of musculus latissimus dorsi flap and split breast flap are useful for the repairing of skin and soft tissues defects.
关键词
胸壁肿瘤
外科手术
胸壁重建
骨水泥
Chest-wall tumor Surgical operation Chest-wall defect Bone cement.
