脱细胞真皮基质修复咽部黏膜和颈部皮肤缺损的临床观察

The clinical observation of the repair of pharyngeal mucosa and neck skin defects with acellular dermal matrix

目的:探讨使用脱细胞真皮基质(ADM)修复咽喉癌不同部位缺损的临床效果。方法:对23例咽喉鳞状细胞癌患者进行回顾性分析,其中下咽癌16例,术后咽喉部出现内侧面的下咽腔组织缺损;喉癌7例,术后出现颈部皮肤组织缺损。使用ADM对上述缺损进行修复,观察修复效果。结果:ADM修复下咽部腔内缺损16例,其中1例术后出现局部感染、咽漏;修复颈部皮肤缺损7例,其中2例出现ADM干燥,并与其下方软组织脱离,最终ADM脱落,引起下方软组织感染、咽瘘。结论:使用ADM修复咽喉癌手术引起的组织缺损,具有组织相容性好、免疫排斥反应低、材料来源广泛、修复方法简单易行的优点,但在修复内侧面的腔内缺损和外侧面的皮肤缺损疗效上有差异,在临床中需要注意的侧重点有所不同。

Objective：To evaluate the clinical effect of ,1cellular dermal matrix （AI）M） on the repair of different tissue defects in pharyngeal and laryngeal cancer. Method：Twenty-three cases of pharyngeal and laryngeal caneer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal earleer. After surgery, the patients appeared two types of tissue defects respectively： hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. Result：Sixteen cases of hypopharynx tissue defect and 7 eases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. Conclusion： The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatlhility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.