%0 Journal Article
%T 足底恶性黑色素瘤术式选择及疗效分析
%A 卜洁
%A 吴宏伟
%A 张洋洋
%A 李先安
%A 陈柳含
%J 肿瘤防治研究
%D 2019
%R 10.3971/j.issn.1000-8578.2019.18.1330
%X 摘要 目的 探讨足底恶性黑色素瘤术式的选择及疗效。方法 回顾性收集本院2011年3月—2017年12月91例足底黑色素瘤患者的临床资料，探究各术式的优缺点，分析术式、性别、分期、原发灶直径、辅助治疗与足底恶性黑色素瘤预后的关系。结果 植皮修复足底非负重区域术后缺损，皮片Ⅰ期存活率86%，术后并发症少。腓肠神经营养血管皮瓣、隐神经营养血管皮瓣、足底内侧动脉皮瓣及股前外侧游离皮瓣术后皮瓣愈合情况无明显差别，但行股前外侧游离皮瓣患者术后平均住院时间相对较短。术后患者5年生存率67%。不同术式及不同性别的患者5年生存率无差别；Ⅱ期和Ⅲ期患者5年生存率分别为85.0%和40.2%；原发灶最大径≥3 cm和<3 cm患者5年生存率分别为60.6%和83.5%，接受辅助治疗及未接受辅助治疗患者的5年生存率分别为72.0%和51.6%。结论 足底黑色素瘤患者可个体化选择植皮、腓肠神经营养血管皮瓣、隐神经营养血管皮瓣、足底内侧动脉皮瓣及股前外侧游离皮瓣修复原发灶扩大切除后手术创面，术后外形功能良好，远期疗效满意
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%U http://www.zlfzyj.com/CN/abstract/abstract9415.shtml