负压封闭引流技术在颈部巨大恶性肿瘤手术中的应用

目的　探讨负压封闭引流技术（ＶＳＤ）在治疗颈部巨大恶性肿瘤术后缺损创面中的疗效及价值。方法　对１５例侵犯皮肤的颈部巨大恶性肿瘤行肿瘤根治术，应用ＶＳＤ覆盖创面（治疗组）。术后持续给予６６５～７９８ｍｍＨｇ负压引流７２ｈ，然后改用间歇负压治疗（负压治疗５ｍｉｎ，间歇２ｍｉｎ）。术后７～１４ｄ停止负压封闭引流，如创面肉芽组织生长良好行创面植皮术，肉芽组织生长不良则再次行ＶＳＤ覆盖创面治疗１周后，行创面植皮术。另选取９例患者作为对照组，行颈部肿瘤切除加游离组织瓣移植治疗。结果　治疗组的手术时间为２～４ｈ，平均３ｈ；出血量为３００～８００ｍｌ，平均５００ｍｌ。对照组的手术时间为４～８ｈ，平均６ｈ；出血量为５００～１２００ｍｌ，平均８００ｍｌ。治疗组１５例患者共接受１７例次ＶＳＤ创面治疗，经治疗后创面新鲜肉芽组织生长良好，并完全覆盖颈动脉等重要组织结构，术后１～３周创面顺利植皮，植皮愈合率为９４７％。对照组中１例出现移植皮瓣坏死。结论　ＶＳＤ用于颈部巨大肿瘤术后缺损创面的治疗具有操作简单、减少交叉感染、促进创面愈合、患者易耐受等优点，是一种治疗颈部巨大恶性肿瘤术后缺损有效且安全的方法。

Application of vacuum sealing drainage on the defect of large neck neoplasms after surgical procedures

Objective To evaluate the efficacy of vacuum sealing drainage(VSD) in the surgical management of large neck neoplasms.Methods Fifteen patients with neck malignancies(treatment group) were treated with radical surgery,and the wounds were applied with VSD.The drainage tubes were connected with vacuum bottle(negative pressure of 6.65-7.98 mmHg) for 72 hours.Then the intermittent negative pressure was used(every 5 minutes with 2 minutes interval).Seven to fourteen days after surgery,VSD was removed.Wounds with ...