颈外动脉分支远心残端动脉压测定及其逆行供血滋养游离皮瓣的可行性探讨

Measurement of distal stump pressure of branches of the external carotid artery and the feasibility of the distal stumps in retrograde blood supply fashion to nourish the free flap

目的:探讨颈外动脉分支血管远心残端逆行供血滋养游离皮瓣的可行性。方法:在颈外动脉分支血管甲状腺上动脉、舌动脉、面动脉和颞浅动脉置管,连接压力传感器,采用飞利浦监护仪分别测定各分支血管的初始平均动脉压(MAP)和阻断血流后远心残端MAP,初始MAP与残端MAP之比为残端动脉压比值。以文献记载最先成功开展逆行供血模式游离皮瓣的下肢血管残端动脉压比值为参照,分析颈外动脉分支血管远心残端动脉压比值及其驱动游离皮瓣循环的可靠性。结果:本组颈外动脉各分支血管的远心残端动脉压比值均达到70%以上,大于文献记载的下肢血管的远心残端动脉压比值。结论:颈外动脉分支血管阻断后,远心残端可维持足够残端动脉压,逆行供血滋养游离皮瓣具有可行性。

PURPOSE:To measure the stump pressure of branches of the external carotid artery and investigate the feasibility of the distal stumps in reversed blood flow to perfuse the free flap.METHODS:The superior thyroid artery,lingual artery,facial artery and superficial temporal artery were respectively cannulated with a 22 gauge cannula connected to a transducer,which in turn was connected to a Philips monitor,the initial mean arterial pressure(MAP)and distal stump MAP after occlusion were determined.The ratio between initial MAP and the stump MAP was defined as the stump pressure ratio.The stump pressure ratio of the external carotid artery branches in this study and that of the documented lower limb vessel were compared and analyzed.RESULTS:The stump pressure ratio of the branch vessels of the external carotid artery reached more than 70%,greater than the recorded stump pressure ratios of the lower limb vessel.CONCLUSIONS:It is feasible to perfuse the free flap with reversed recipient artery in head and neck region based on the sufficient stump pressure after occlusion of the branch vessels of the external carotid artery.