微血管吻合器在放射性下颌骨坏死游离腓骨瓣移植静脉吻合中的应用  

End-to-end venous anastomoses using the anastomotic microvascular device in mandibular reconstruction with free fibular flap following osteoradionecrosis ablation

作　　者：王友元[1] 张大明[1] 范松[1] 林钊宇[1] 周斌[1] 钟江龙 陈伟良[1] 李劲松[1] 

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面-头颈外科,广州510120

出　　处：《中华显微外科杂志》2015年第1期16-19,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金（81472521）;广州市科技计划项目（11C22060035）

摘　　要：目的 评价微血管吻合器在放射性下颌骨坏死腓骨瓣移植静脉端端吻合中应用的可靠性.方法 2012年9月-2014年2月,采用游离腓骨肌皮瓣重建放射性下颌骨坏死切除术后缺损34例,静脉采用微血管吻合器端端吻合,共用61枚吻合器,其中27例采用双静脉吻合,7例采用单静脉吻合. 结果 34例游离腓骨肌皮瓣静脉吻合口无渗血,术中阻断实验显示静脉通畅、充盈良好;术后皮瓣全部成活.吻合时间较手工吻合明显缩短,平均吻合每条静脉时间约为4.7 min,无手术并发症.术后随访6—22个月,吻合区愈合良好,无排异反应. 结论 微血管吻合器可应用于放射性下颌骨坏死游离腓骨瓣移植的静脉端端吻合,可缩短吻合时间,吻合质量可靠,操作简便.Objective To assess the reliability and usefulness of using a coupling device for end-to-end venous anastomosis in patients undergone fibular graft in mandibular reconstruction following osteoradionecrosis ablation.Methods From September,2012 to February,2014,34 patients undergone surgical osteoradionecrosis resection and mandibular defects were repaired with fibular flap.The anastomotic microvascular device was used to perform venous anastomosis in these case series.Flap survival and thrombosis of the venous anastomoses were determined.Results There were no flap losses due to venous thrombosis in this series.The venous anastomosis was usually coupled in about 4.7 minutes and appear as an obviously time savings compared with performing a hand-sewn venous anastomosis.Conclusion The anastomotic microvascular device is reliable and excellent in end-to-end venous anastomosis and certainly less taxing on the surgeon when compared with standard suture techniques.

关 键 词：放射性骨坏死 下颌骨缺损 腓骨瓣 微血管吻合器 显微外科技术 

分 类 号：R782.2[医药卫生—口腔医学]