游离皮瓣两种动脉吻合方式在重建口腔颌面部组织缺损中的对比分析  

Comparative analysis of two arterial anastomosis of free flaps in reconstruction of oral and maxillofacial tissue defects

作　　者：朱晓雨 尼加提·努尔穆罕默德 买买提吐逊·吐尔地[1] ZHU Xiaoyu;Nijiati Nuermohanmode;Maimaitituxun Tuerdi(Orthognathic and Traumatic Department of Oral&Maxillofacial Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院(附属口腔医院)口腔颌面创伤外科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2021年第2期205-209,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2016D01C249)。

摘　　要：目的探讨游离皮瓣动脉端端吻合(EEA)与动脉端侧吻合(ESA)在重建口腔颌面部缺损中的血流动力学差异。方法回顾性分析2018年10月—2019年12月间38例游离皮瓣重建口腔颌面部缺损患者的临床资料。依据术中动脉吻合方式的不同分为EEA组和ESA组,对术后血管危象发生率、皮瓣坏死率和术后早期血流动力学指标进行统计分析。结果两组的皮瓣坏死率及血管危象发生率差异无统计学意义(P>0.05)。ESA组在术后1 d、术后3 d、术后7 d的收缩期峰值速度及血流量均大于EEA组(P<0.05)。结论在游离皮瓣重建口腔颌面部组织缺损中,两种动脉吻合方式的皮瓣成活率及血管危象发生率无明显差异,但术后早期1~7 d的血流动力学指标ESA优于EEA。从血流动力学方面证实了ESA在游离皮瓣移植修复颌面部缺损中的临床实用性及可靠性。Objective To discuss the hemodynamic difference between arterial end-to-end anastomosis(EEA)and end-to-side anastomosis(ESA)of free flap in reconstructing oral and maxillofacial defects.Methods The clinical data of 38 patients with free flap reconstruction of oral and maxillofacial defects admitted to the hospital from October 2018 to December 2019 were retrospectively analyzed.According to different intraoperative arterial anastomosis methods,they were divided into EEA group and ESA group.The incidence of postoperative vascular crisis,flap necrosis rate and early postoperative hemodynamic indexes were statistically analyzed.Results There was no statistical difference in flap necrosis rate and vascular crisis rate(P>0.05).And the peak velocity and blood flow of systole in the arterial ESA group were greater than that in the arterial EEA group at day 1,day 3,and day 7 after the surgery(P<0.05).Conclusion In the reconstruction of oral and maxillofacial tissue defects with free flaps,the two arterial anastomosis methods have no significant difference in the survival rate of the flap and the incidence of vascular crisis,but the hemodynamic indexes of ESA in the early 1-7 days after surgery were better than those of EEA.Further,the clinical practicability and reliability of arterial end-to-end anastomosis in repairing maxillofacial defects with free flap transplantation were confirmed from the aspect of hemodynamics.

关 键 词：游离皮瓣 动脉端端吻合 动脉端侧吻合 血流动力学 

分 类 号：R782.5[医药卫生—口腔医学]