摘要
目的探讨股阴部V-Y型推进皮瓣重建外阴手术方法的疗效。方法对17例外阴肿瘤患者依据病情分别行外阴单纯切除、外阴局部广泛或广泛切除,术后分别通过股阴部V-Y型推进皮瓣、股薄肌肌皮瓣、腹壁浅动脉轴型皮瓣、股阴部非筋膜菱型带蒂移位皮瓣行外阴重建,观察术后感染、切口愈合、拆线时间、瘢痕增生等指标的情况。结果5例行股阴部非筋膜菱形带蒂移位皮瓣重建患者中,2例出现右侧皮瓣远端约0.5 cm×1.0 cm张力性水泡及坏死,经换药后Ⅱ期愈合;3例Ⅰ期愈合术后均有不同程度感觉障碍如麻木或痛觉缺失。1例行腹壁浅动脉轴型皮瓣因动脉血栓形成大部分肌皮瓣坏死经清创后Ⅱ期愈合。1例行双侧腹壁下动脉轴型皮瓣Ⅰ期愈合。10例采用股阴部V-Y型推进皮瓣或改良后皮瓣重建外阴,均Ⅰ期愈合,转移皮瓣无感觉障碍,外阴形态及阴毛分布等外观理想。结论V-Y型推进皮瓣重建外阴治疗效果好,并发症少,同时缩短了手术时间,是目前较为理想的手术方法。
Objective To explore the curative effect of V-Y advancement medial thigh flap for the reconstruction of vulvoperineal region. Methods Retrospective analysis of clinical data of 17 cases of vulvar neoplasm actual, Simple vulvectomy, local extensive vulvectomy or wide excision were performed, and V-Y advancement medial thigh flap, gracilis myocutaneous flap, axial flap with superficial epigastric artery and non-fascia link-based pedicled medial thigh flap were used for vulvae reconstruction. Main outcome postoperative infection, wound healing, removal of stit- ches time and scar formation were measured. Results Tension bullaes with the scale 0.5 cm × 1.0 cm and necrosis in right flap were observed in 2 patients with non-fascia link-based pedicled medial thigh flaps, wounds were healed by second intention after dressing change. Sensory disturbance such as numbness and alganesthesia were observed in the other 3 patients with non fascia link-based pedicled medial thigh flaps. Myocutaneous flap necrosis was observed in one patient with axial flap with superficial epigastric artery because of arterial thrombosis, wounds were healed by second intention after debridement. A routine bilateral epigastric artery flap healing. Primary healing was observed in 10 patients with V-Y advancement medial thigh flaps or modified flaps, and no sensory disturbance was found,in addition, vulvo-morphology, pubes distribution etc were satisfied. Conclusion V-Y advancement medial thigh flap used for the reconstruction of vulvoperineal region produced a good efficacy and few complication, and reduced operation time, which could be an ideal operative procedure.
出处
《实用临床医学（江西）》
CAS
2009年第10期62-65,共4页
Practical Clinical Medicine
关键词
外阴切除
外阴重建
肌皮瓣
股阴部
vulvectomy
vulvae reconstruction
myocutaneous flap
medial thigh
