五、治疗
(一)一般治疗
局部广泛手术切除,术后行植皮或皮瓣修复术。
(二)口腔颌面部异常相关的治疗建议
发生在颌面部恶性溃疡治疗主要依靠手术切除,放射治疗较手术效果差。原因是:①瘢痕区血运不良,疗效差;②癌瘤多分化良好,对放射敏感性差。癌瘤已侵犯深部组织及重要组织,可考虑彻底切除后同期行皮瓣移植修复。为了防止恶性溃疡的发生,灼伤后应迅速给予适当处理。如局部治疗、控制感染、早期行植皮术以及保护瘢痕等。
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(郑晓姣 王志勇)