口腔颌面部107例复合组织游离移植中血管吻合经验

EXPERIENCES OF VASCULAR ANATOMOSES IN FREE TRANSPLANTATION OF 107 COMPLEX FLAPS IN ORAL-MAXILLOFACIAL SURGERY

本文总结我科12年间对口腔颌面部各种形式的缺损畸形进行吻合血管复合组织游离移植修复和重建术107例中血管吻合术的经验。该组病例中男64人,女43人,平均年龄33.8岁(13～68岁)。游离复合组织瓣全部成活99例,皮肤少许坏死2例,失败6例,总成功率94.4％。共吻合血管241对,其中端端吻合203次,三点式套缝28次,端侧吻合5次。失败例中因动脉血栓或供血不足造成的4例,因血管蒂受压和血管蒂过短造成的各1例。文章讨论了口腔颌面部血管吻合的特点,介绍了一些特殊血管吻合的方法。

Since 1978, 107 Patients with oral-maxillofacial defect have been repaired by free transplantation of vascularized complex flap in our department.There were 64 males and 43 females in this group, and 33.8 year-old-age in average.The total success rate reached to 94.4% and 6 cases failed.Anastomosed vessels were 241 pairs, among of which there were 203 end-to-end, 28 sleeve and 5 end-to-side anastomoses.In failed cases, 4 were because of artery block or ischemia, one pedecle pressed, and another short of pedicle.Other complications were analysed in the article.The characteristics of vascular anastomose were discussed, some special anastomosis methods were introduced, for example, 2:1 end-to-end and shrinked anastomoses for the vesseles of large discrepancy in calibre.