游离组织瓣修复头颈部术后缺损并发组织瓣坏死的原因分析  

Analysis for the reason of postoperative complications of free tissue flaps which were used to repair the vacancy of head and neck tumors

作　　者：魏宏明[1] 李振东[1] 刘宏伟[1] 李树春[1] 

机构地区：[1]辽宁省肿瘤医院头颈外科,辽宁沈阳110042

出　　处：《中国耳鼻咽喉头颈外科》2013年第12期617-620,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨游离组织瓣修复头颈部术后缺损并发组织瓣坏死的原因,以期提高手术成功率。方法对63例应用游离组织瓣修复的头颈恶性肿瘤术后缺损的临床资料进行回顾性分析。结果术后出现血管危象11例,危象发生率17.46%。其中静脉危象9例,动脉危象2例,最终皮瓣坏死4例,坏死率6.35%。与术后并发症有关的术前因素包括年龄、糖尿病、高凝状态、长期吸烟史及长期适量饮酒史;术中因素包括血管蒂过长、吻合血管组数;术后因素包括术后引流及激素治疗。结论对拟行游离组织瓣修复头颈部术后缺损的患者,进行完善的术前评估,严格掌握手术适应证以及周全的术中、术后处理是减少手术并发症、提高成功率的关键。OBJECTIVE To study the reason ofpostoperative complications of free tissue flaps in order to improve the success rate of the surgery. METHODS The clinical data of 63 patients who were used free tissue flaps to repair the postoperative defects of the head and neck tumors were retrospectively analyzed. RESULTS There were 11 cases presented vascular crisis after the surgery, the rate of vascular crisis was 17.46%. Of the 11 cases, 9 cases were vein crisis and 2 cases were artery crisis. At last, flap necrosis occurred in 4 cases, and the necrosis rate was 6.35%. Pre-operative factors which were related to postoperative complications included age, hypertension, hypercoagulable state, long history of smoking and drinking. The factors during the operation were the too long of the vascular pedicle and the number of anastomosis vessels. Postoperative factors were drainage after the operation and hormone therapy. CONCLUSION The proper preoperative assessment, appropriate operative indication, and comprehensive intraoperative and postoperative treatment are crucial to reduce the complications and increase the success rate of the free tissue flaps surgery.

关 键 词：头颈部肿瘤 外科皮瓣 血管外科手术 手术后并发症 术前评估 

分 类 号：R739.91[医药卫生—肿瘤]