两种手术路径切除马德龙病巨大脂肪瘤效果研究

Study on the effect of two surgical paths for removal of large lipoma of Madron disease

目的改良手术路径分离超薄皮瓣,更有效切除马德龙病巨大脂肪瘤并修复创面。方法回顾性分析本院2017年4月-2019年4月期间收治的19例颈部良性对称性脂肪瘤病患者进行研究,根据不同手术路径分为改良组及常规组,两组分别为10例、9例。改良组采用新手术路径:先在深筋膜浅层分离肿瘤,再切取超薄皮瓣同时切除肿瘤;常规组为常规手术路径:先切取超薄皮瓣,再切除肿瘤。分析出血量、皮瓣成活率、感染率、手术时间等效果。结果改良组出血量明显减少,皮瓣成活率增加,感染率降低,手术时间缩短。结论应用先从深筋膜层分离脂肪瘤,再分离出超薄皮瓣并切除脂肪瘤的改良性手术路径,能够显著减少出血量及感染率,提高超薄皮瓣成活率,建议在临床可推广应用于马德龙病的手术治疗。

Objective To improve the surgical path to separate ultrathin flaps,and to effectively remove large fatoma of Madron disease and repair wounds.Methods Retrospective analysis of 19 patients with benign symmetrical lipomatosis who were admitted to our hospital from April 2017 to April 1919,and divided into improved group and regular group according to different surgical paths.The improved group used a new surgical path:firstly,the tumor was separated in the shallow fascia,and then the ultrathin flap was removed to remove the tumor.The conventional group was the conventional surgical procedure:the ultrathin flap was first removed and the tumor was removed.Analyze the effects of blood loss,flap survival rate,infection rate,and operation time.Results The amount of bleeding in the modified group was significantly reduced,the survival rate of the flap was increased,the infection rate was reduced,and the operation time was shortened.Conclusion The application of an improved surgical approach to separate lipoma from the deep fascia and then separate the ultrathin flap and remove the lipoma can significantly reduce the amount of bleeding and infection,and improve the survival rate of ultrathin flap.It can be applied to the surgical treatment of Madron disease.