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目的 :探讨血管吻合器在口腔颌面部游离皮瓣血管吻合中的应用效果。方法 :2014年9月—2015年5月,对21例患者行口腔颌面部组织缺损游离皮瓣修复创面,供血动脉选用面动脉及甲状腺上动脉,回流静脉选用颈外静脉及颈内静脉分支。手工吻合游离皮瓣动脉18条,吻合器吻合游离皮瓣动脉3条、静脉21条;其中头静脉13条,腓动脉伴行静脉6条,股前外侧动脉伴行静脉2条,观察其吻合时间及吻合血管通畅率。采用SPSS l7.0软件包进行统计学分析。结果:吻合后勒血试验证实,动脉和静脉血流通畅率100%。动脉吻合中,供血动脉选用面动脉16次,甲状腺上动脉5次;回流静脉选用静外静脉13次,颈内静脉分支8次。手工吻合动脉平均时间为(17.20±2.31)min,吻合器动脉吻合平均时间为(5.48±1.33)min;手工吻合静脉平均时间为(18.39±3.48)min,吻合器吻合静脉平均时间为(6.45±0.60)min。术后随访游离皮瓣全部成活,缺损修复后皮瓣颜色、形态及质地良好,未出现皮瓣危象及皮瓣坏死。术后血管彩超均显示吻合后动脉吻合口血流通畅,无血栓形成。术后1~3个月复诊,均未见皮瓣坏死。结论:应用血管吻合器吻合静脉速度快,通畅率高,初步结果证明该血管吻合器安全、有效,在一定程度上可节约手术时间。
Objective: To investigate the application of vascular stapler in vascular flap anastomosis of oral and maxillofacial region. METHODS: From September 2014 to May 2015, 21 patients underwent oral and maxillofacial tissue defect free flap to repair the wound. The facial artery and thyroid artery were selected for feeding artery and the jugular vein and jugular vein branch . Manual anastomosis free flap arteries 18, anastomosis anastomosis free flap arteries 3, 21 veins; of which 13 cephalad, femoral artery accompanying vein 6, anterolateral arteries with 2 veins, observe the anastomosis Time and vascular patency rate. SPSS l7.0 software package for statistical analysis. Results: Anastomosis blood test confirmed that arterial and venous patency rate of 100%. Artery anastomosis, the selection of arteries for the feeding artery 16 times the upper thyroid artery 5 times; intravenous intravenous use of intravenous vein 13 times, jugular vein branch 8 times. The average duration of manual anastomosis was (17.20 ± 2.31) min and the average time of anastomosis was (5.48 ± 1.33) min. The average duration of manual anastomosis was (18.39 ± 3.48) min, and the mean time of anastomotic anastomosis was (6.45 ± 0.60) min. The free flaps survived after the operation. The flap color, shape and texture were good after the defect was repaired. There was no skin flap crisis and flap necrosis. Postoperative vascular ultrasound showed an anastomosis of the anastomosis blood flow, no thrombosis. 1 to 3 months after referral, no skin necrosis. Conclusion: The application of vascular stapler anastomosis of the vein speed, patency rate, preliminary results show that the vascular stapler is safe and effective, to a certain extent, can save the operation time.