游离组织瓣修复头颈部缺损手术后的管理  

Postoperative management of free flap transfer for the repair of the defects in head and neck region

作　　者：殷卫红[1] 王力敏[1] 戚道一[1] 刘静明[1] 朱正宏[1] 

机构地区：[1]首都医科大学附属北京同仁医院口腔科,100730

出　　处：《实用口腔医学杂志》2004年第1期97-99,共3页Journal of Practical Stomatology

摘　　要：目的 :探讨头颈部游离组织瓣移植围手术期的管理 ,形成临床常规。方法 :3 3例游离组织瓣显微血管吻合修复面颈部缺损 ,对其围手术期所发生的问题进行分类 ,分析可能影响组织瓣成活的各种因素、围手术期用药及处理。结果 :3 3例游离组织瓣 3 2例成功 ,1例失败 ,成功率为 97.0 %。 2例出现静脉血栓 ,组织瓣血栓的发生率为 6.1% ,重新手术探查吻合 ,1例成功 ,另 1例坏死 ,抢救成功率为50 %。术后并发症的发生率为 3 6.4%。结论 :游离组织瓣移植最易出现的并发症是血管危象和血肿 。Objective:To summarize the experience in the postopera ti ve management of free flap transfer for the repair of the defects in head and ne ck region. Methods:Thirty three free flaps were transfere d to repair head and neck defects.The factors that may influence the survive of the flaps,and the way that may be used to handle those problems were analyzed. Result: Thirty two of the thirty three free flaps surviv ed and one was lost. The overall free flap success rate was 97.0% .Thrombosis of vein developed in 2 patients. By flap salvage, one flap survived,the other ex perienced total failure. The total postoperative complication rate was 36.4% inc luding thrombosis,infection,bleeding,wound break and so on.Corresponding treatme nt was given and all the flaps were kept except one mentioned above. Conclution:The most common complications in free flaps transfer are v essel thrombosis and hematoma. Timely salvage can prevent the necrosis of the flaps

关 键 词：游离组织瓣 修复 头颈部缺损 手术后管理 围手术期 皮瓣移植 并发症 

分 类 号：R782.2[医药卫生—口腔医学] R622.1[医药卫生—临床医学]