摘要
目的:探讨如何提高头颈部游离组织瓣移植的成功率。方法:2004年1月至2004年12月间,由同一手术小组完成的连续194例患者的200块游离组织瓣移植,分析所采用组织瓣的类型、受区血管、游离瓣成活情况及术后并发症的发生情况,并探讨提高游离瓣可靠性的重要环节。结果:本组共采用7种游离瓣,包括腓骨瓣、前臂皮瓣、大腿前外侧皮瓣、空肠瓣、腹直肌皮瓣、肩胛瓣和背阔肌皮瓣。游离瓣的临床成功率为99.5%,术后血管危象的发生率为2%,抢救成功率为75%;受区和供区总并发症发生率为24.2%。结论:合理选择游离瓣、熟练的游离瓣制备技术、选择理想的受区血管、简化实用的血管吻合技术及游离瓣术后的有效监测,是提高头颈部游离瓣移植成功率的重要环节。如果各个环节处理得当,头颈部游离组织瓣移植的成功率应当接近100%。
PURPOSE: To analyze the reliability and safety of free flap transfers in head and neck reconstruction. METHODS: Two hundred consecutive free flap transfers performed in 194 patients from January of 2004 to December of 2004 were reviewed. Data concerning the operation included date of surgery, defect description and site, stage and histology of tumor, flap type, recipient vessel and complications. RESULTS: Seven kinds of free flap were used in this series, they were free fibular flap, free radial forearm flap, free anterolateral thigh flap, free jejunal flap, free rectus abdominis flap, free scapular flap, and free latissimus dorsi flap. The overall success rate of free flap was 99.5%. The overall complication rate was 24.2%. The vessel thrombosis rate was 2%, and the flap salvage rate was 75%. CONCLUSIONS: Free flap in head and neck reconstruction is very safe and reliable. The success rate can reach nearly 100% if every precaution is taken before, during, and after operation.
出处
《中国口腔颌面外科杂志》
CAS
2005年第2期134-138,共5页
China Journal of Oral and Maxillofacial Surgery
关键词
游离瓣
显微外科
头颈部重建
Free flap
Microsurgery
Head and neck reconstruction
