Coupler在头颈肿瘤术后缺损修复重建的应用:285例吻合器的临床应用经验  

Coupler’s application in reconstruction of postoperative defects of head and neck tumors:285 clinical experiences with Coupler

作　　者：李晓光[1] 刘忠龙 黄忠亮 苏瑜 任振虎[1,2] 邓刚 LI Xiao-guang;LIU Zhong-long;HUANG Zhong-liang;SU Yu;Ren Zhen-hu;DENG Gang(Department of Oral and Maxillofacial&Head and Neck Oncology,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of oral and maxillofacial surgery,Hainan Western Central Hospital,Hainan Danzhou 571700,China;The 2nd Dental Center,Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Stomatology,Hainan Western Central Hospital,Hainan Danzhou 571700,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科,上海200011 [2]海南西部中心医院口腔颌面外科(张志愿院士工作站),海南儋州571700 [3]上海交通大学医学院附属第九人民医院口腔第二门诊,上海200011 [4]海南西部中心医院口腔科,海南儋州571700

出　　处：《临床口腔医学杂志》2020年第9期540-543,共4页Journal of Clinical Stomatology

基　　金：海南省卫生计生行业科研项目(18A200154);海南西部中心医院院士工作站科研基金(2019)。

摘　　要：目的:探讨Coupler血管吻合器在头颈肿瘤根治术后缺损游离皮瓣修复中应用的可行性、有效性及其临床应用价值。方法:收集2017年5月~2019年12月口腔颌面外科行游离皮瓣修复头颈部缺损的患者285例,男197例,女88例,年龄范围36~77岁。所有皮瓣静脉的吻合方法是Coupler血管吻合器,皮瓣动脉的吻合方法为任氏血管吻合法或等距双定点间断缝合法。结果:每条静脉血管吻合时间在2~8 min,平均5.5 min,术中阻断实验显示血管通畅,充盈良好;共发生9例皮瓣危象,其中静脉危象8例,动脉危象1例。其中6例皮瓣抢救成功,3例皮瓣坏死。皮瓣的总体成功率是98.9%。结论:Coupler血管吻合器与常规血管吻合法相比可以明显缩短静脉血管吻合手术时间且操作简便,建议口腔颌面部缺损修复中应用推广。Objective:To investigate the feasibility,effectiveness and clinical value of Coupler vascular stapler in the reconstruction of free flap of defect in head and neck radical resection.Methods:From May 2017 to December 2019,285 cases of head and neck defects were repaired by free flap in the department of oral and maxillofacial head and neck oncology,197 males and 88 females.The method of minsanastomosis of all flap veins was the Coupler vascular stapler,and the method of anastomosis of flap arteries was the Ren anastomosis or the classical vascular anastomosis.Results:The anastomosis time of each vein was 2~8 minutes,with an average of 5.5 minutes.There were 9 cases of flap compromise,including 8 cases of venous occlusions and 1 case of arterial occlusion.Among them,6 cases of flap were rescued successfully,3 cases of flap necrosis.The overall success rate of the flap was 98.9%.Conclusion:Compared with conventional vascular anastomosis,coupler can significantly shorten the operation time of venous anastomosis and is easy to operate.Therefore,it is suggested to popularize the application of this method in the repair of oral and maxillofacial defects.

关 键 词：Coupler血管吻合器 游离皮瓣 修复重建 任氏血管吻合法 头颈肿瘤 

分 类 号：R782.2[医药卫生—口腔医学]