1260例游离股前外侧皮瓣移植术后引起皮瓣坏死的相关因素分析  

Analysis of related factors of postoperative necrosis in 1260 cases of free anterolateral thigh flap transplantation

作　　者：陶先耀 薛明宇 糜菁熠 施海峰 陆征峰 赵刚 强力 周晓 张志海 许亚军 芮永军 Tao Xianyao;Xue Mingyu;Mi Jingyi;Shi Haifeng;Lu Zhengfeng;Zhao Gang;Qiang Li;Zhou Xiao;ZhangZhihai;Xu Yajun;Rui Yongjun(Department of Orthopedic,Wuxi Ninth People’s Hospital(Wuxi Orthopaedic Hospital),Wuxi 214062,Jiangsu Province,China)

机构地区：[1]无锡市第九人民医院(无锡市骨科医院)骨科,江苏无锡214062

出　　处：《中国临床解剖学杂志》2024年第5期517-522,共6页Chinese Journal of Clinical Anatomy

基　　金：无锡市“太湖人才”顶尖医学团队和“滨湖之光”医学专家团队项目支持。

摘　　要：目的对我院游离股前外侧皮瓣坏死的影响因素进行总结,并对相关的影响因素进行探讨和分析。方法收集2014年6月至2024年6月我院手术的1260例游离股前外侧皮瓣的相关信息,对23个相关的影响因素进行分析,包括患者特点、术前因素、术中因素和术后因素。将这些影响因素与皮瓣坏死结果进行单因素分析和多变量Logistic回归分析。结果1260例游离股前外侧皮瓣成活1167例(92.6%),坏死93例(7.4%)。经统计学分析得出:静脉吻合数量、皮瓣感染、皮瓣下血肿、血管危象与游离股前外侧皮瓣的坏死密切相关。结论静脉血管吻合数(≥2)会增加血液回流,皮瓣更易成活;术中彻底清创、精确止血和充分的引流会减少皮瓣感染和血肿的发生,可以减少皮瓣坏死;术后及时发现动静脉血管危象并对应的处理,可以提高皮瓣成活率。Objective To summarize the influencing factors of free anterolateral thigh flap necrosis in our hospital,and to discuss and analyze the related influencing factors.Methods A total of 1260 free anterolateral femoral flaps operated in our hospital from June 2014 to June 2024 were collected,and 23 related influencing factors were analyzed,including patient characteristics,preoperative factors,intraoperative factors,postoperative factors.Univariate analysis and multivariate logistic regression analysis were performed on these influencing factors and the results of flap necrosis.Results 1260 free anterolateral thigh flaps survived in 1167 cases(92.6%)and necrotic in 93 cases(7.4%).Statistical analysis showed that the number of venous anastomosis,flap infection,subflap hematoma,vascular crisis were closely related to the necrosis of the free anterolateral femoral flap.Conclusions Venous vascular anastomosis(≥2)can increase blood return and make the flap more viable,and thorough debridement,precise hemostasis and adequate drainage during surgery can reduce the occurrence of flap infection and hematoma,reduce flap necrosis,and timely detection and treatment of arteriovenous crisis after surgery can improve the survival rate of flap.

关 键 词：游离股前外侧皮瓣 危险因素 坏死 回归分析 

分 类 号：R616.2[医药卫生—外科学]