摘要
目的：总结鼻咽癌治疗后颈部淋巴结转移灶复发并侵犯皮肤的临床特点及治疗情况。方法：回顾性分析23例鼻咽癌治疗后颈部淋巴结转移灶复发并侵犯皮肤的临床特点，23例行根治性颈淋巴结清扫＋胸大肌肌皮瓣修复手术．21例术后行放化疗。结果：鼻咽癌治疗后颈部淋巴结转移灶复发并侵犯皮肤的I陆床特点有：患侧颈部皮肤呈桔皮样改变（14例）、溃疡（9例），患侧头部牵拉痛（7例）。术中见颈部各层解剖间隙消失．胸锁乳突肌萎缩，肿瘤与颈鞘粘连，颈内静脉变形或闭锁。术后22例术创延期愈合（15—72d），1例因肿瘤残留术创不愈。随访至2012年3月，23例患者无瘤生存15例，远处转移6例，局部复发2例．其中带瘤生存3例．死亡5例。结论：鼻咽癌治疗后颈部淋巴结转移灶复发侵犯皮肤可选择行根治性颈淋巴结清扫＋胸大肌肌皮瓣修复手术，术后行放化疗，可获得较好疗效。
Objective To sum up the effects of surgical treatment and clinical features of encroaches on the skin of recurrent cervical metastasis of nasopharyngeal carcinoma. Methods 23 cases of encroaches on the skin of recurrent cervical metastasis of nasopharyngeal carcinoma were treated with radical neck dissection add up repairing operation of pectoralis major myocutaneous flap. 21 cases were combined with radiotherapy and chemotherapy after operation. Results Clinical features of encroaches on the skin of recurrent cervical metastasis foci were such as the neck skin got peau deorange （14 cases）, skin ulcer （9 cases）, head referred pain （7 cases）. There were intraoperative features like these： layers of anatomic space disappearing, sternocleidomastoid atrophy, adhesion of tumor and carotid sheath, vena jugularis interna deformed or obturator. 22 cases were delayed union （15-72 d） after operation. Following up these cases to March 2012 we found there were 15 cases tumor-free survival, 6 cases with distant metastasis, 2 cases of local recurrence 3 cases of 8cases were survival with tumor and 5 cases died. Conclusions Encroaches on the skin of recurrent cervical metastasis loci for nasopharyngeal carcinoma were treated with radical neck dissection add up repairing operation of pectoralis major myocutaneous flap, then combined with radiotherapy and chemotherapy after operation, can have very good clinical effect.
出处
《实用医学杂志》
CAS
北大核心
2013年第21期3552-3555,共4页
The Journal of Practical Medicine
基金
广西科学研究与技术开发计划项目(编号:桂科攻0816004-10)
关键词
鼻咽肿瘤
根治性颈淋巴结清扫
胸大肌肌皮瓣
Nasopharyngeal neoplasms
Radical neck dissection
Pectoralis major myocutaneous flap
