头皮肿瘤手术方法的改进

头皮肿瘤手术的改进 ?60? polymerfollowedbyradiationtherapyinthe treatll,.eiltofnewlydiagnosedmali~antgliomas. PhaseItrlalJNeurooncol,l95526:il1 8.DonelliMG.ZucehettiM.D'IncalciM.Do antieanceragentsreachthetumortargetinthe humanbran?CancerChemotberPharmaco1,l992I 3O,251 7.BakhshiSandNorthRB.1mplantab]epumpsfor drugdeliverytothebrain.JNeuro--Oncol'1995j 26z133 8.HarbaughRE.SaundersRL?ReederRF.Useof implantaplepumpsforcentralnervoussystemdrug infusionstotreatneurologicaldisease. NeuvOsurgery?1988l23;693 9.Pardr(dgeWMRecentdevelopmentsinpsptide drugdeliverytothebrain.pharmacolToxico,19921 72:3 10.MakM.FungL.StrasserIF?ets1.Dist~ibntion ofdrugsfollowingcontrolleddeliverytothebrain interstitium,JNeuro--Onco1.1995I26,91 l1.Buah|hKGandBremH.1nterstitialchemotherapy ofexpsriraentalbraintumors:comparisonof intratumoralinjectionversuspolymericcontrolled release.JNeuro,OI1衄】,1995'26:103 12.MeneiP,BenoitJP.Boisdron--CelleM,eta1.Drug targetingintothecentralnervoussystemby stereotactieimplantationofbiodegradable mierospheres.Neu~osurgery,1994l34:1058 临床神经外科杂志1997年第2卷第1期 13.LangerR.NewmethodsofdrugdeliverytScience? l99Ot249:1527 14.TamargoR./,My~crosJs,EpsteinJI.ellInterstitial chemotherapyofthe9LgliosarcomaIcontrolled releasepolymersfordrugdeliveryinthebrain. CancerRes.1993'53;329 15.BremH.TamargoRJ.OliviA?eta1. Biodegradablepolymersforcontrolleddeliveryof chemotherapywithandwithoutradiationtherapy inthemonkeybrain.JNeurosurg?1994'80:283 16.GrossmanSA.RelnhardC,ColvinOMteta1.The intracerebraldistributionofBCNUdeliveredby surgicallyimplantedbiodegradablepolymers.J Neurosurg?1992l78;640 17.YangMB,TamargoRJ,BremH?Control~d deliveryofl,3一bis(2一chloroetby1)一l— nitrosoureafromethylene—vinylacetate copolymer.CancerRes,1989l495103 18.BrernH.MahaleyMS,VickNA?eta1. Interstitia]chemotherapywithdrugpolymer implantsforthetreatmentofrecurrentghomas.】 Neurosurg,199I}74:441 19.Brem.H.PiantadoslS.BurgerPC,eta1.Placebo — controlledtrialofsa~etyandeflicacyof intraoperativecontrolleddeliverybybiodegradable polymersofchemotherapyforrecurrentgliomas. Lancet.1995'345:1008 (1996-12-30收稿) 头皮肿瘤手术方法的改进 810014西宁中国人民解放军第四医院神经外科詹万孝张学糜 头皮恶性肿瘤传统的手术方法出血较多?为此作 者作了改进具体方法是常规消毒,局麻(麻醉范围较 常规方法稍大)后先在预定手术切口线外围0.5,lcm 处用7号丝线连续间断缝合一周.相邻两针之间适当 重叠以彻底阻断肿瘤组织的血藏供应.尔后常规方法 切除肿瘤及其周目部分头皮,油纱布敷盖削面,包扎伤 口即可.无需加压包扎.术后3天拆除头皮缝拽此法 的优点是术中无出血,易于彻底切除肿瘤组织,且手术 时间短头皮缝合一周后伤口收缩,使头皮缺掼及刨面 面积缩小l0左右,非但不影响刨面愈合?匣而可缩短 愈合时问.并为二期头皮移植刨造了良好条件.拆线后 亦不发生头皮切缘及创面出血. fl996-I1-12收稿)