静脉留置针在深部游离组织瓣移植中监测血供的临床应用  

Clinical application of intravenous catheter in monitoring blood supply of deep free flap graft

作　　者：胡广伟[1] 廖天安[1] 王鸿[1] 邱勋永[1] 

机构地区：[1]海南省人民医院口腔科,海南海口570311

出　　处：《中国美容医学》2012年第7期1151-1153,共3页Chinese Journal of Aesthetic Medicine

基　　金：海南省卫生厅资助项目(2007-26)

摘　　要：目的:评价静脉留置针在深部游离组织瓣移植中监测血供的临床应用价值。方法:应用腓骨肌(皮)瓣、髂骨肌骨瓣、前臂皮瓣等游离移植修复组织缺损的病例共26例,年龄22～70岁,在深部游离组织瓣静脉远心端留置静脉针,术后通过静脉留置针输注低分子右旋糖酐,20ml/h,持续7天,并给予罂粟碱30mg肌肉注射,1次/8h,抗凝及扩血管处理。结果:7天内观测25例静脉留置针滴注通畅,有1例患者在术后48h内出现静脉留置针滴速变慢,给予灌注稀释肝素生理盐水后阻力恢复正常。26例深部组织瓣全部存活,未出现血管危象。结论:静脉留置针在深部游离组织瓣移植应用能持续监测组织瓣血管通畅状况,有效预防静脉血栓形成,提高组织瓣的成活率。Objective To assess the clinical application value of intravenous catheter in monitoring blood supply of deep free flap graft. Methods 26 cases of tissue defects which were reconstructed by free radical fibular osteocutaneous flap,iliac osteomusculocutaneous flap,forearm flaps,the age from 22 to 70,were treated with intravenous catheter from distal vein of deep free flap by which intravenous drip dextran-40 were given,average 20 milliliter each hour and last 7 days.The patients were given narceine 30mg, intramuscular injection every 8 hour anticoagulation and vasodilator therapy by routine. Results Distal intravenous catheter of 25 cases kept fluent, and intravenous catheter of 1 case appeared slow,became normal after repeated infusion of dilute heparin saline.26 cases＇deep free flaps were all survived without occurring vascular crisis. Conclusion Application of intravenous catheter in deep free flap graft can monitor blood supply of free flap continuously, prevent venous thrombosis effectively and improve flap survival.

关 键 词：静脉留置针 游离组织瓣 血管危象 

分 类 号：R782[医药卫生—口腔医学]