面动脉伴行静脉作为自体颌下腺移植回流静脉的可靠性探讨

Reliability of venae comitant of facial artery as the donor vein in microvascular autologous submandibular gland transfer

目的探讨面动脉伴行静脉作为血管化自体颌下腺移植供区静脉的可靠性，以期为临床提供指导。方法对1999年8月至2007年11月期间完成的117例共122侧血管化自体颌下腺移植回顾性研究，根据腺体移植时所选用供区静脉的不同，将全部病例分成3组：面静脉组（93侧）、伴行静脉组（27侧）和腺门静脉组（2侧），并分析各组腺体移植术后静脉危象的发生率及其处理情况。结果术后共有16侧移植腺体出现静脉危象，其中面静脉组14侧（15％），伴行静脉组2侧（7％），两者差异有统计学意义（P〈0．01）。面静脉组中有7侧因静脉危象导致失败（8％），伴行静脉组中有2侧因静脉危象导致失败（7％），两者差异无统计学意义（P〉0．05）。结论面动脉伴行静脉是自体颌下腺移植可靠的回流静脉，只要管径合适，面动脉伴行静脉应作为自体颌下腺移植的首选供区静脉。

Objective To analyse the reliability of concomitant venae of facial artery as the donor vein in mierovascular autologous submandibular gland transfer. Methods One hundred and seventeen cases with severe keratoconjunctivitis sicca treated by microvascular transfer of autogeneous submandibular gland transfer from August of 1999 to November of 2007 were reviewed. The cases were divided into three groups according to their different donor veins, with group A using facial veins, group B using concomitant venae of facial artery, and group C using a vein near the duct. Group A and B were compared in terms of venous thrombosis rate and failure rate related to venous thrombosis. Results Among 117 cases, there were 122 sides of submandibular gland transfers, with 93 in group A, 27 in group B, and 2 in group C. Postoperative venous thromboses rate was 15% in group A and 7% in group B, with significant difference （ P 〈 0.01 ）. The failure rate of transfered gland related to venous thrombosis was 8% in group A, and 7% in group B, with no significant difference （ P 〉 0. 05 ）. Conclusions Concomitant venae of facial artery can be used as reliable donor vein in microvascular autologous submandibular gland transfer.