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ONE-STAGE RECONSTRUCTION OF LAGRE THROUGH-AND-THROUGH DEFFECT OF CHEEK WITH ACOMBINATION OF FOREHEAD SKIN FLAP AND STERNOCLEIDOMASTOID ISLAND MYOCUTANEOUSFLAP AFTER CANCER DISSECTION

Objective To study the methods and results of a combination of forehead skin flap and sternocleidomastoid island myocutaneous flap in the reconstruction of large through-andthrough defect of check. Methods One case of check cancer received ampliative resection and functional neck dissection. The defect area of the skin side was 9 cm×7 cm, of the mucosa side 4.5 cm×3.0 cm.The defect of the mucosa side was repaired with sternocleidomastoid island myocutaneous flap which blood supply was from thyroidea superior artery, occipitalis artery and carotis extera vein; of the skin side with forehead skin flap which blood supply was from temporalis superficialis artery and vein. The size of the sternocleidomastoid island myocutaneous flap was 5 cm×3 cm, of the forehead skin flap10 cm×6 cm. Results Two flaps and the split survived after operation. One-stage healing was achieved. The patient was discharged from hospital 2 weeks afteroperation.The color and the quality were good.The tumor did not recur during follow-up of one year. The patient could take care of herself, and she lived normally in talk and diet. Conclusion A combination of forehead skinflap and sternocleidomastoid island myocutaneous flap is a useful method to repair large through-and-through defect of cheek after cancer dissection. It is easy-to-operate and economical.

急性轮状外层视网膜病变一例

前臂游离皮瓣修复口腔组织缺损五例

纵隔、胸腔双引流在防治食管癌手术后并发症发生中的应用

目的探讨纵隔、胸腔双引流在防治食管癌手术后并发症发生中的临床意义。 方法回顾性分析2010年1月至2013年10月淮南市东方医院集团总院胸心外科174例食管癌手术治疗患者的临床资料，根据术后引流方式不同将其分为两组，纵隔、胸腔双引流组：96例，男59例、女37例，年龄（60.75±6.28）岁，术后行纵隔、胸腔双引流；对照组：78例，男46例、女32例，年龄（62.36±5.24）岁，术后常规单纯胸腔引流。比较两组术后胸腔引流管带管时间、胸腔残余积液发生率、肺部感染发生率和心脏并发症发生率等。 结果纵隔、胸腔双引流组患者术后吻合口瘘发生率与对照组差异无统计学意义（2.1% vs.2.6%，P>0.05）。纵隔、胸腔双引流组2例发生吻合口瘘，均经保守治疗治愈。对照组2例发生吻合口瘘，1例经二次手术治愈；1例术后出现发热，术后3周因心肺功能衰竭死亡。纵隔、胸腔双引流组术后胸腔引流管带管时间［（71.86±7.43）h vs.（123.12±10.05）h］、胸腔残余积液发生率、肺部并发症发生率（13.5% vs.26.9%）、心脏并发症发生率（16.7% vs.32.1%）均低于对照组（P<0.05）。随访156例，失访17例，随访时间3～12个月，无严重手术相关并发症发生。 结论纵隔、胸腔双引流在食管癌手术中不能降低吻合口瘘的发生率，但可以减少心肺并发症的发生，有利于患者术后恢复。