摘要
目的：探讨胸壁肿瘤术后几种重建胸壁缺损方法的效果。方法：分析我院自１９６５年５月～１９９８年４月期间所行胸壁大块组织切除及重建７０例，良性肿瘤３８例，恶性肿瘤２３例，转移性肿瘤９例。所有肿瘤均切除３～５根肋骨。胸壁缺损面积８ｃｍ×１５ｃｍ × １９ｃｍ× ２３ｃｍ。１４例用克氏钢针，２５例用不锈钢丝，２６例用涤纶（Ｄｅｃｒｏｎ）网修复胸壁缺损。结果；全组无手术死亡，除３例伤口感染和２例呼吸困难外，其他病人恢复良好。术后分别有５例发生远处转移及局部复发。结论：胸壁缺损修复时，骨性支撑硬质材料以钢丝、软质材料以网状材料为最佳，前胸及侧胸壁的缺损应两种材料同时应用，以防止术后反常呼吸的发生，Ｄａｃｒｏｎ网具有组织相容性好、成本较低等优点，但其制作材料和工艺仍需改进。
objective: The repair and reconstruction of giant chest wall defect is considered complex and difficult.The goal this psper is to study several methods of repair and reconstruction after extensive chest wall tumor resection. Methods: Retrospective analysis of 70 patients with chest wall tumor resection and repair of chest wall defect from May 1962 to April 1998 in our department.Thirty-eight patients had benign, 23 had malignant and 9 had metastatic carcinoma.Whether benign or malignant tumor, 3-5 ribs were resected.The areas of defect were about 9 × 15cm to 19 × 23cm. Fourteen needles, twenty-five stainless steel wire and twenty-six Dacron polyester net were used for reconsruction. Results: All, except three, achieved primary wound healing. There was no operation death and tumor metastasis occurred in 5 patients and 5 had local recurrences. Conclusion: When repairing the defect of giant chest wall, it is the better way for skeletal reconstruction to use non-stainless steel wire as hard material and net as soft material. If the defect is located in anterior or lateral chest wall, it is better using both material in order to prevent paredoxical respiration. The Dacron net has better histocompatibility and is cheaper, but it needs to improve the raw material and production technic.
出处
《重庆医学》
CAS
CSCD
1999年第5期326-327,共2页
Chongqing medicine
关键词
胸壁肿瘤
胸壁缺损
胸壁重建
外科手术
Chest wall tumor Defect of chest wall Reconstruction of chest wall
