头颈部组织缺损显微外科重建的临床效果

Clinical effect of head and neck reconstruction using microsurgical free flap transfer techniques

目的介绍头颈部组织缺损的显微外科重建技术及其临床应用效果。方法选用血管蒂较长和血管口径较粗的游离组织瓣供区,选择口径粗大和位置合适的受区血管,将游离瓣制备成外露瓣,以利于术后血供的监测,在手术放大镜下行血管吻合,部分病例同时吻合2根静脉,以确保游离瓣的静脉回流。结果施行1007例共1066块游离组织瓣移植修复头颈部组织缺损。临床成功率为98.3%,术后血管危象的发生率为3.1%,抢救成功率为45.5%。结论应用显微外科技术施行游离组织瓣移植重建头颈部组织缺损,可获得良好的临床效果。

Objective To analyze our clinical results of head and neck reconstruction using microsurgical free flap transfer techniques. Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed, and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope. The un-buried free flap with a monitoring window were harvest, and do double venous anastomoses in some flaps to ensure adequate venous out- flow. Results From May 1999 to March 2005, 1 066 consecutive free flap transfers were used to reconstruct head and neck defects. The overall success rate of free flap was 98. 3%. The vessel thrombosis rate was 3.1%, and the flap salvage rate was 45.5 %. Conclusion Head and neck reconstruction using microsurgi- cal free flap transfer technique is safe and reliable, and good clinical results can be obtained.