摘要
目的探讨前臂皮瓣游离移植修复口腔颌面部缺损术后血管危象的成因及处理方法。方法自2002年2月至2013年3月，笔者对136例口腔颌面部肿瘤患者行肿瘤切除术联合同期前臂皮瓣移植修复术，其中，27例患者出现血管危象。对出现血管危象者，剪开血管吻合口，以肝素生理盐水反复冲洗后重新缝合，并以针刺法监察皮瓣成活情况。结果本组27例移植皮瓣出现血管危象，其中，动脉危象6例，静脉危象21例。经抢救及重新吻合后，15例皮瓣均成活，抢救成活率55．6％。结论前臂皮瓣游离移植术后对血运的临床观察是非常重要的，早期及时发现血管危象并及早处理是避免皮瓣坏死的有效方法。
Objective To explore the cause of formation and management of postoperative vessel thrombosis after free transplantation of forearm flap on the repair of oral and maxillofacial defect. Methods From February 2002 to March 2013, totally 136 patients with oral and maxillofacial tumor underwent surgical resection and free transplantation of forearm flap at one stage. Vessel thrombosis occurred in 27 cases. Heparin saline wash and clinical monitoring by needling were carried out in these 27 cases. Results Twenty-seven cases with vessel thrombosis were studied in this group, with 6 cases of arterial thrombosis and 21 cases of venous thrombosis. All cases were cured after the rescue management, and 15 flaps （55. 6% ） survived. Conclusion Postoperative clinical monitoring of the free transplantation of forearm flap is very important. Meanwhile, look out the vessel thrombosis at the early stage and take an effective management as soon as possible are both practical to avoid flap necrosis.
出处
《中国美容整形外科杂志》
CAS
2013年第6期340-342,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
颌面部缺损
前臂皮瓣
游离移植
血管吻合
血管危象
Oral and maxillofacial defect
Forearm flap
Free transplantation
Vascular anastomosis
Vessel thrombosis
