应用显微外科技术治疗侵袭性纤维瘤病

Application of the technology of microsurgery to repair defect of the soft tissue owing to the aggressive fibromatosis

目的 分析侵袭性纤维瘤病的临床和病理特点 ,以及报道应用显微外科技术治疗的临床效果。 方法 选择累及肢体功能的侵袭性纤维瘤 7例 ,均实施瘤体切除 ,其中 2例在手术显微镜下分离受累神经 ,1例直接切除受累的神经后行肌腱转位功能重建 ,2例皮肤缺损行皮瓣转移修复 ,1例肌腱感染坏死行肌腱移植修复 ,1例行神经分离并静脉移植修复动脉缺损。 结果 3例累及神经者术后肢体肌力恢复基本正常达M4～M5 ,感觉恢复接近正常达S+ 3 ～S4,2例皮瓣修复皮肤缺损外形满意 ,1例桡神经损伤行功能重建恢复伸腕 ,伸指功能 ,1例血管移植修复肢体远端血运正常。复发 1例 ,再次行手术切除 ,术后随访 1 5年无再次复发。 结论 对侵袭性纤维瘤切除术后的组织缺损应用显微外科技术进行修复 。

Objective To report the clinic and pathological character and to study clinical effect of the technology of microsurgery in the treatment of the aggressive fibromatosis Methods To select seven cases which were involved by the aggressive fibromatosis After cleared the tumorous changes position, the technology of microsurgery were used to repair the soft tissue defect such as nerve and vessel and tendon Results In 4 cases, the function of limb nerves involved by the aggressive fibromatosis recovered satisfactory Three cases were applied successfully with the transplanted tissue survived and with the transplanted vessel One case recrudesing after the first operation re operated with satisfactory recover followed up one and half years Conclusions Repairing defect of tissue owing to operation of the aggressive fibromatosis with the technology of microsurgery can obtain better appearance and function of limb