Kết quả sử dụng vạt da cơ lưng to trong tạo hình khuyết phần mềm thành ngực

5. Zou XN, Lu SH, Liu B (1994). Volatile N￾nitrosamines and their precursors in Chinese salted fish￾a possible etological factor

6. For NPC in China. Int J Cancer 1994, No 59: 155-

158.

7. Armstrong RW,lmrey PB, Lye MS, Armstrong MJ,

Yu MC, Sani S (2000). Nasophryngeal carcinoma in

Malaysian Chinese. Occupational exposures to particles

formaldehyde and heat. Int J Epidemiol 2000, No 29:

991-998

8. Chan JKC, Pilch BZ, Kuo TT, Wenic BM, Lee

AWM (2005). Tumor of the nasopharynx in Pathology

and Genetics of Head and Neck Tumours, Edited by L.,

Eveson JW, Reichart P, Sidransky D. I ARC Press Lyon

2005: 86-99.

KET QUA Sir DUNG VAT DA C0 LUNG TO

TRONG TAO HINH KHUYET PHAN MEM THANH NGUC

TOM TAT

SCf dijng 23 vat da ca lang to cudng mach liin cho

23 binti nhan cd khuyet thanh ngae rdng. Nguyen

nhan loit man tinh thanh ngae 39,73%, da nach va

vung ngi/c sau xa tri 52,17%), khuyit sau cit bo ung

tha vu 8,70%). Kit qui che phd va tai tao thanh ngae

dat tot 93,75%,.

TCrkhda: vat da ca lang, khuyit thanh ngae.

SUMMARY

The use 23 pedicled latissimus dorsi

myocutaneous flaps in 23 patients with large chest

waH defects. Cause: chronic ulcer of chest wall

39.13%o, axillary and chest zone skin after radiation

therapy 52.17%, defects of recurrent mastectomy

8.70%. The result of thoracic wall reconstruction and

cover 93.75%) successful.

Keywords: pedicled latissimus, chest waH defects.

OAT VAN o i

Khuyet thanh ngUe la mot tinh trang benh ly do

nhieu nguyen nhan. Mdt trong nhi]fng nguyen nhan

ehinh gay ra tdn thUdng mac phai b thanh ngUe la

nhilm trimg. Dd cd the la hau qua cua chan thUdng,

viem nhilm vimg trung that, viem mu mang phdi, cudi

cimg la sU hoai ti!f thanh ngUc.Sau khi xif tri nhilm

trimg, ngUdi ta dung cac vat td chifc lay tir viJng lUhg

hoac vimg bung de tai tao thanh nguc. Mpt sd trUdng

hdp khi phlu thuat eat bd khdi u xuong Cic, lay bd khdi

u vu, hoac u thanh ngUe khae, vung tdn thuong dUde

eat bo tao ra khuyet mdi can dupe phiu thuat tai tao.

NgUdi ta chia khuyet thanh ngUc ra hai nhdm: khuyet

mac phai va khuyet bam sinh. Khuyet mac phai gdm

nhilm trimg gay loet, cat bd khdi u, loet ngUc sau xa

tri, ch^n thUdng. Khuyet bam sinh la hoi chimg

Poland.[1I

Nam 1906, Tansini [5] bat dau sijf dung cd lung to

va mpt manh da lay kem vdi cd de cfie phu khuyet

thanh ngUc thanh cdng. Ke do, nhieu nha khoa hpc

tren the gidi da nghien cifu va img dung cd hieu qua

ky thuat nay trong ngoai khoa.,[2],[3],[4],[6] Chiing tdi

thdng bao ket qua sijf dung vat da cd lung to trong tao

hinh che phu cac khuyet rpng phan mem thanh ngUc

b ngudi Viet Nam.

NGUYI N ROA N TUA T - irudng d^i hgc y Hd Ngi

Lt GIA VINH - Hgc vi$n Quin y

OOI TUONG vA PHUONG PHA P NGHIEN CUU

Trong nghien cifu nay chimg tdi sijf dung 23 vat da

cd lung to cudng macti lien tao hinh cho 23 benh

nhan ed khuyet thanh ngUe rpng.

Gdm 14 benh nhan cd khuyet rpng b thanh ngUc

trudc. Nhumg benh nhan nay cd tdn thUdng loet thanh

ngUe do xa trj sau cat bd ung thu vu. Phiu thuat cat

bd d loet va vimg da, cd xd cimg, khuyet thanh ngUc

mat da va cd, khong tdn khuyet xUdng, khong cd

benh ly phdi hdp khac trong Idng ngUc. Cd 8 benh

niian khuyet thanh nguc trudc vimg ben phai; 6 benh

nhan khuyet thanh ngUc trudc vimg ben trai.

Cac benh nhan khuyet thanh ngUc ben gom 9

benh nhan, trong dd 4 benh nhan bj khuyet ben phai

va 5 benh nhan bi khuyet ben trai. Benh nhan sau

dieu trj tia xa gay xd cimg vimg nachi, vimg thanh

ngUc ben, phii bach mach chi tren. Sau khi phiu

thuat cat bo tdn thUdng vung thanh ngirc ben cd

khuyet da va phan mem rpng can tao hinh che

phu.Tat ca benh nhan deu la nOf, tudi tir 29 den 65.

Vat da cd lung to cimg ben vdi vimg thanh nguc

cd khuyet dUdc sii dung. Vat dudi dang cudng mach

lien dupc bdc khdi vung lung, td chifc vat nuoi dudng

bang cudng mach lien. Vat chuyen qua dudng ham tir

lung sang thanh ngUc de phu khuyet. Cd djnh vat vao

thanh nguc bang cae mui ehi khau nylon 4-0 mui rdi.

KET QUA vA BA N LUAN

Tat ea 23 benh nhan cd khuyet rpng thanh ngUe

dupc phiu thuat tao hinh che phu khuyet trong

nghien cifu deu la jiCf. Chi sd trung binh ve tudi cac

benh nhan nay la X= 52,61. Lifa tudi g§p nhieu hdn

tir 36 den 55 tudi chiem 56,52%, day la tudi trung

nien - tudi lao dpng chinh.

Nguyen nhan khien ngUdi benh den benh vien de

phiu thuat, chimg tdi chia thanh ba nhdm benh.

Nhdm thir nhat nhiJng benh nhan cd vung loet man

tinh thanh nguc, cac vet loet la di chimg cua xa tri

39,13%. Nhdm thir hai la cac benh nhan dUdc xa trj

vimg thanh ngUc va nach sau ung thu vii. Da vung xa

trj xd cimg gay nhifc nhdi khd chju can phiu thuat cat

bo, nhdm nay 52,17%. Nhdm thif ba sau phiu thuat

Y HOC THirC HANH (751) - S6 2/2011 27