自体肋骨及人工材料联用重建胸壁巨大缺损

Associated autologoustissue with artificial prosthesis to reconstruct giant chest wall defect

目的 探讨联合应用自体组织及人工材料重建胸壁缺的方法和疗效.方法 回顾性分析9例胸部外伤和6例胸壁肿瘤切除后所致胸壁巨大缺损患者采用自体组织及人工材料联合应用的方法进行骨性胸壁重建的临床资料.结果 所有患者术后恢复良好,全部治愈出院,胸腔引流管在5 d内拔除,平均住院时间（15.7±3.4）d.4例因并发呼吸窘迫综合征行呼吸机辅助治疗5 d,顺利脱机.术后随访6～12个月,平均（9.3±0.7）个月,患者均恢复良好.结论 自体肋骨和人工材料联合应用重建胸壁缺损,具有操作简单、取材方便的优点,且临床疗效确切,值得推广应用.

Objective To evaluate the method and therapeutic effect with reconstruction of giant chest wall defect using associated autologous-tissue with artificial prosthesis. Methods To retrospectively analyze clinical data of 15 patients with giant chest wall defect （ including 9 cases with thoracic injury and 6 cases with chest wall tumor resection）, all patients had performed skeletal reconstruction of chest wall and associated autologoustisse with artificial prosthesis. Results The postoperative recovery of all patients were good and healing well, their intrathoracic drain tube were pulled out in 5 days after operation and their average stay were （15.7 ± 3.4） days. Although 4 cases had been complicated by respiratory distress syndrome and performed adjunctive therapy with breathing machine for 5 days, the four patients had good postoperative recovery. The mean follow-up period was （9.3 ±0.7） months （from 6 to 12 months ） and all patients had successfully restored the stability of chest without death or severe complication. Conclusion Using associated autologous-tissue with artificial prosthesis to treat chest wall giant defect is a convenient and simple method, which shows well therapeutic effects and promising application.