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顱面部周圍型神經纖維瘤切除后修復重建

總結手術治療顱面部周圍型神經纖維瘤（craniomaxillofacial neurofibroma，CMFNF）的效果。方法 1999年5月～2003年8月，收治CMFNF患者27例。男10例，女17例；年齡2~70歲。病程2~50年。涉及瘤體的皮膚面積20~110 cm2，其中gt;100 cm2 6例，50~100 cm2 16例，lt;50 cm2 5例。多科合作進行CMFNF手術切除和顏面外形功能重建。一期手術25例，其中15例采用5 cm×3 cm～12 cm×7 cm皮瓣修復CMFNF切除后缺損，余直接縫合。二期手術2例。結果 術后切口均Ⅰ期愈合，皮瓣均成活；骨缺損修復和眼眶再造造型好。20例獲隨訪2~6年，無再次手術，術后容貌明顯改善，患者均可參與正常的社會活動。結論 多科合作手術切除及修復是治療CMFNF的首選方法。

小腿內側皮瓣修復手部創傷47例

我科自1983年5月～1993年5月，應用小腿內側皮瓣整復手部創傷47例(48側)。隨訪時間1～10年，效果滿意。手術后無1例發生供瓣側下肢功能障礙，皮瓣成活率97.9%。對小腿內側皮瓣應用于手部創傷中的特點作了討論。

體表血管瘤的治療綜述

ONE STAGE REPAIR OF SCROTAL AND PERINEAL HYPOSPADIAS WITH PREPUCE ISLAND FLAP

Objective To explore an effective method to repair penile-scrotal or perineal hypospadias in one stage with prepuce island flap.Methods Different prepuce island flaps were designed according to thedifferent pathological anatomy of the penile-scrotal or perineal hypospadias. The prepuce island flaps were thus translocated and sutured to form the urethra.Thirty-one cases of hypospadias (21 cases of peinil-scrotal type, 10 cases of perineal type) were repaired with prepuce island flap.The biggest length and the width of the prepuce island flapwere 7.5 cm and 1.5-1.8 cm respectively.Results All the cases resulted in a good contour of the penis and a normal anatomic position of urethral meatus without any redundancy or tortuosity.The urination was perfect and acceptable.Conclusion One stage repair of penilescrotal or perineal hypospadias with prepuce island flap can be considered as an acceptable effective surgical technique.