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目的:探讨侵犯气管的分化型甲状腺癌术后,应用带蒂舌骨下肌群肌骨瓣修复的可行性。方法:对2006年1月至2010年12月共10例侵犯气管的分化型甲状腺癌行根治性切除术,受累气管窗式切除,应用带蒂舌骨下肌群肌骨瓣修复,术后辅助131Ⅰ治疗。结果:10例患者均术后3月拔除气管套管,拔管率100%,术后定期复查电子支气管镜,肌骨瓣均存活,重建气管腔壁上皮化,无明显狭窄;随访5年,远处转移死亡1例。结论:带蒂舌骨下肌群肌骨瓣有良好的血供,远期效果好,拔管率高,是分化型甲状腺癌气管部分切除后的理想修复组织。
OBJECTIVE: To investigate the feasibility of repairing pedicled musculocutaneous flap of hyoid muscle after operation on differentiated thyroid carcinoma with tracheal invasion. Methods: From January 2006 to December 2010, a total of 10 cases of invasive thyroidectomy for tracheobronchial carcinoma underwent radical resection. Tracheostomy was performed by tracheostomy. 131 Ⅰ treatment. Results: All the 10 patients were removed with tracheal cannula after 3 months, the rate of extubation was 100%. Electron bronchoscope and musculocutaneous flap were reexamined after operation. The epithelialization of tracheal wall was reconstructed with no obvious stenosis. After 5 years of follow-up, Distant transfer of death in 1 case. CONCLUSION: Musculocutaneous flap with submucus muscles of the pedicel has a good blood supply, good long-term effect and high extubation rate. It is an ideal repair tissue after partial resection of the trachea of differentiated thyroid cancer.