神经纤维瘤的整形外科治疗

Plastic surgery of neurofibroma

目的研究和探索不同部位和类型的神经纤维瘤及神经纤维瘤病的整形外科治疗的效果。方法37例神经纤维瘤均采用手术治疗,其中,切除后直接缝合8例,肿瘤皮片回植9例,皮瓣转移12例,应用扩张器皮瓣修复5例,异体皮覆盖自体微粒皮移植3例,对不同部位与不同类型的神经纤维瘤的治疗方法中的要点进行了分析和探讨,总结了神经纤维瘤的主要临床表现、治疗原则以及手术治疗中的注意事项。结果37例中,25例为孤立性神经纤维瘤,11例为Ⅰ型神经纤维瘤病,1例为Ⅱ型神经纤维瘤病。37例患者经手术治疗后,效果均较满意。结论神经纤维瘤的治疗,要根据其病变的部位与类型,采用不同的治疗方法,尽可能在彻底的切除瘤体组织的基础上,可以争取达到功能及外观恢复的最佳效果。

Objective To study the reconstructive treatment of the different types of neurofibroma and neurofibromatosis in different locations. Methods 37 patients with neurobibroma or neurofibromatosis were reviewed, including 8 cases with simple suture after excision, 9 cases with skin grafting in situ, 12 cases with skin flap grafting. The main points of the treating methods for different types of neurofibroma and neurofibromatosis were discussed, and the chief clinical manifestations, therapeutic principle and notices of the operation were then summarized. Results These 37 patients, including 25 cases of neurofibroma, 11 cases of neurofibromatosis type Ⅰand 1 case of neurofibromatosis type Ⅱ , were satisfied with the results after reconstructive operation. Conclusion The methods of reconstructive operation of neurofibroma and neurofibromatosis, such as simple suture after excision, skin grafting in situ, skin flap grafting, the use of skin soft tissue expansion, microskin grafting and so on, must be selected according to the different type and location of the neurofibroma and neurofibromatosis. The reconstructive operation must guarantee the best recovery of the visage and the function on the basis of the most degree of tumor excision.