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手术联合免疫疗法治疗皮肤恶性黑色素瘤的疗效分析[J]. 肿瘤防治研究, 2012, 39(04): 442-445. DOI: 10.3971/j.issn.1000-8578.2012.04.019
引用本文: 手术联合免疫疗法治疗皮肤恶性黑色素瘤的疗效分析[J]. 肿瘤防治研究, 2012, 39(04): 442-445. DOI: 10.3971/j.issn.1000-8578.2012.04.019
Curative Effect of Malignant Melanoma on Skin Treated by Surgical Method Combined Immunotherapy[J]. Cancer Research on Prevention and Treatment, 2012, 39(04): 442-445. DOI: 10.3971/j.issn.1000-8578.2012.04.019
Citation: Curative Effect of Malignant Melanoma on Skin Treated by Surgical Method Combined Immunotherapy[J]. Cancer Research on Prevention and Treatment, 2012, 39(04): 442-445. DOI: 10.3971/j.issn.1000-8578.2012.04.019

手术联合免疫疗法治疗皮肤恶性黑色素瘤的疗效分析

Curative Effect of Malignant Melanoma on Skin Treated by Surgical Method Combined Immunotherapy

  • 摘要: 目的 探讨采用手术联合免疫疗法治疗皮肤恶性黑色素瘤的临床疗效。方法1998年8月—2010年12月,对收治的34例皮肤MM患者按照无瘤技术在一定深度与广度完整切除肿瘤病灶,根据创面部位、大小、深度,遵照“宁近勿远,宁简勿繁”的原则,分别选择皮瓣或皮片修复创面;术后按照“扶正驱邪”理论,选择免疫治疗做为辅助治疗,并按期随访。结果14例采用18个皮瓣修复,皮瓣均100%成活,术区外形与功能良好;13例于术后7~132月得到随访,9例存活,4例死亡;存活者中最长1例已无瘤健康存活11年。18例皮片修复者中,7例皮片存活率为95%左右,经换药愈合;其余11例皮片成活率均为100%,术区外形与功能均良好;15例术后12~120月随访结果显示,9例存活,6例死亡。2 例分别行掌指/跖趾关节离断术者,伤口一期愈合,现分别为手术后15月与24月,全身情况良好,局部无任何复发迹象。结论手术联合免疫治疗是目前治疗皮肤恶性黑色素瘤的良好方法。

     

    Abstract: Objective To probe the curative effect of malignant melanoma on skin treated by surgical method combined immunotherapy. Methods From August 1998 to June 2011,34 patients with malignant melanoma on skin were treated in our department.A focus was excised totally on a certain depth and width using non-tumor technique,then according to the site,area and depth of wound and the principle of “rather near than further,rather simple than complicated”,a flap or skin graft was employed to repair the wound.Then according to the theory “strengthening the body resistance to eliminate pathogenic factors”,immunotherapy was selected as an accessory treatment after operation,and follow-up was carried out on schedule. Results Of fourteen cases repaired by 18 skin flaps,all of skin flaps survived,and the appearance and function of operative areas were good.Among them,13 patients were followed up from seven months to eleven years after operation.Nine patients survived and four died,and in the survivors,one case already survived eleven years without tumor.Of eighteen cases repaired with skin grafts,the survival rate of skin graft was about 95% in seven cases,the wounds healed by dressing change.In the other cases,the survival rate of skin grafts reached 100%,and satisfactory appearance and function of operative areas appeared.In those patients,fifteen patients were followed up from one year to ten years after operation,and the results showed nine patients survived and six died.Two cases were carried out metacarpophalangeal or metatarsophalangeal joint amputation respectively,the incision healed on the first stage.Now they were in fifteen months and two years after operation,general condition was very well,and no any local recurrence was appeared. Conclusion It might be a good method to treat malignant melanoma on skin with surgical method combined immunotherapy at present.

     

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