皮瓣的静脉危象及其处理

Venous crisis of flaps and its management

目的:探讨皮瓣静脉危象的发生发展规律,寻求防治方法,提高皮瓣移植及移位手术的成活率。方法:总结1973～1995年间1176例各类皮瓣手术中,30例失败的原因及18例应用"二套静脉回流系统"的效果。结果:30例失败病例中因动脉危象失败5例,因静脉危象失败25例,其中受区静脉高压返流失败12例。49例在大面积皮瓣手术中18例应用"二套静脉回流系统"全部成活。结论:在皮瓣手术中应高度重视受区与供区静脉的处理,提供"二套静脉回流系统"是防治静脉危象的关键性措施。

Objective: To investigate the rule of venous crisis in flap transfer and to find the methods of its prevention and treatment to improve the survival rate of flap transfer. Methods: 30 failures out of 1175 cases of flaps were analyzed. Double venous drainage system was used in 18 cases. Results: 5 out of the 30 failure cases were caused by arterial crsis. 25 were venous crisis and 12 of which had high pressure back flow in the recipient vein. 'Double venous drainage system' were used in 18 out of 49 flaps with large area and all the flaps survived. Conclusions: Emphasis should be placed on the management of the veins of the donor and recipient sites. 'Double venous drainage system' is a key technique to prevent venous crisis.