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目的 探讨累及双侧的舌癌根治术后全舌体、口底重建的有效方法及临床评价。方法 对 2 0 0 0年 10月至 2 0 0 2年 12月间我科收治的 7例累及双侧的舌癌患者实施根治性手术 ,造成全舌体、口底的大面积缺损 ,采用一侧胸大肌岛状肌皮瓣转移即时重建全舌体和双侧口底。结果 6例转移肌皮瓣完全成活 ,口腔和颈、胸部创面均一期愈合。 1例肌皮瓣远端部分皮肤坏死 ,但无口底颌下瘘和感染等并发症发生。术后随访 2～ 16个月 ,重建舌体、口底形态基本满意 ,语言功能大部分恢复 ,吞咽功能恢复良好。 1例在术后 9个月死于肿瘤肺转移 ,其余 6例目前均健在。结论 胸大肌岛状肌皮瓣组织量大 ,血供丰富 ,是全舌体、口底重建的理想选择。
Objective To investigate the effective methods and clinical evaluation of whole tongue and mouth reconstruction after bilateral radical mastectomy of the tongue cancer. Methods From October 2000 to December 2002 in our department admitted to the seven cases of bilateral tongue cancer patients underwent radical surgery, causing the entire tongue, the mouth of the large area of the defect, using a Transversal pectoralis major myocutaneous flap for immediate reconstruction of the whole tongue and bilateral mouth. Results Six cases of metastatic myocutaneous flaps survived completely, and the mouth and neck and thoracic wounds healed in one time. One case of myocutaneous flap distal part of the skin necrosis, but no mouth fistula and infection and other complications. The patients were followed up for 2 to 16 months. The tongue body was reconstructed. The shape of the floor of the mouth was basically satisfactory. Most of the language functions were restored and the swallowing function recovered well. One patient died of tumor lung metastasis 9 months after operation, and the remaining 6 patients were currently alive. Conclusion The pectoralis major myocutaneous myocutaneous flap has a large amount of tissue and abundant blood supply. It is an ideal choice for whole tongue and mouth reconstruction.