股前外侧穿支皮瓣游离移植中单静脉吻合和双静脉吻合的对比研究

A comparative study of single vein anastomosis and double vein anastomosis in free transplantation of anterolateral femoral perforator flap

目的探索在股前外侧穿支皮瓣游离移植治疗前臂创面时吻合静脉数量对临床疗效的影响。方法回顾性分析2012年7月至2019年7月沈阳医学院附属中心医院手外科106例应用股前外侧穿支皮瓣游离移植治疗前臂创面的患者的临床资料,其中吻合静脉数量为一条的患者56例(A组),吻合静脉数量为两条的患者50例(B组)。对两组患者手术时间、术后静脉栓塞发生率、二次手术率以及皮瓣成活率进行比较,并进行统计分析。结果 A组平均手术时间短于B组(P<0.05),A组静脉栓塞发生率显著高于B组(P<0.05),而A组需要二次手术探查率显著高于B组(P<0.05),两组皮瓣成活率比较差异无统计学意义。结论应用股前外侧穿支皮瓣游离移植修复前臂的创面时,吻合两条静脉可以显著减低静脉栓塞发生率、降低二次手术风险,值得临床推广。

Objective To explore the effect of the number of anastomotic veins in the treatment of forearm wound by free transplantation of anterolateral femoral perforator flap. Methods From July 2012 to July 2019, the clinical data of 106 patients with forearm wound treated by free transplantation of anterolateral femoral perforator flap in hand surgery of Affiliated Central Hospital of Shenyang Medical College were analyzed retrospectively, including 56 patients with one anastomotic vein(group A) and 50 patients with two anastomotic veins(group B). The time of operation,the incidence of venous embolism, the rate of second operation and the survival rate of flap were compared between the two groups. Results The average operation time of group A was significantly shorter than that of group B(P<0.05), the incidence of venous embolism in the group A was significantly higher than that in the group B(P<0.05), while the rate of second operation exploration in the group A was significantly higher than that in the group B(P<0.05), and there was no significant difference in flap survival rate between the two groups. Conclusion Anastomosis of the two veins can significantly reduce the incidence of venous embolism and the risk of secondary operation, which is worthy of clinical application.