CAJ | 학술논문

目的探讨显微血管吻合新方法的可行性、有效性及临床应用价值.方法收集2013年2至5月在中南大学湘雅二医院口腔颌面外科行游离皮瓣修复口腔癌术后组织缺损患者108例(109块皮瓣),男性78例,女性30例,年龄31～73岁.根据显微血管吻合不同方法将109块皮瓣分为试验组(46块皮瓣)和对照组(63块皮瓣),试验组显微动脉的吻合方法为本研究设计并首先应用的等距双剪口套叠缝合法(简称:四针法),对照组为常规的等距双定点间断缝合法(简称:常规法),两组的显微静脉吻合方法均为常规的间断吻合法.结果试验组的动脉吻合时间为(7.3±1.7) min,对照组为(14.5±2.6)min,差异有统计学意义(P=0.00).试验组无动脉危象发生,出现1块静脉危象并发生皮瓣坏死,对照组动脉危象1块、静脉危象2块,其中1块静脉危象抢救失败,皮瓣坏死.结论四针法具有缝合定点准确、省时高效、通畅率高等优点,可作为颌面部重建常用游离皮瓣动脉吻合的一种可选方法.
목적 탐토현미혈관문합신방법적가행성、유효성급림상응용개치.방법 수집2013년2지5월재중남대학상아이의원구강합면외과행유리피판수복구강암술후조직결손환자108례(109괴피판),남성78례,녀성30례,년령31～73세.근거현미혈관문합불동방법장109괴피판분위시험조(46괴피판)화대조조(63괴피판),시험조현미동맥적문합방법위본연구설계병수선응용적등거쌍전구투첩봉합법(간칭:사침법),대조조위상규적등거쌍정점간단봉합법(간칭:상규법),량조적현미정맥문합방법균위상규적간단문합법.결과 시험조적동맥문합시간위(7.3±1.7) min,대조조위(14.5±2.6)min,차이유통계학의의(P=0.00).시험조무동맥위상발생,출현1괴정맥위상병발생피판배사,대조조동맥위상1괴、정맥위상2괴,기중1괴정맥위상창구실패,피판배사.결론 사침법구유봉합정점준학、성시고효、통창솔고등우점,가작위합면부중건상용유리피판동맥문합적일충가선방법.
Objective To evaluate the feasibility and clinical significance of the new method for microvascular anastomosis.Methods Between February 2013 and May 2013,108 patients aged 31 to 73 years underwent free flap reconstruction of the defects as a result of resection of oralmaxillofacial tumors.Of 108 patients,78 were men and 30 were women.The cases were divided into experimental group (46 flaps) and control group (63 flaps) according to different methods of microvascular anastomosis.Isometric double notches end to end microvascular anastomosis was used for artery anastomosis in experimental group,conventional end to end anastomosis was used for artery anastomosis in control group and venous anastomosis was performed in both groups.Results The entire procedure of artery anastomosis took (7.3 ± 1.7) min in experimental group,(14.5 ± 2.6) min in control group,the difference between the two groups was significant (P =0.00).There was only one venous compromise which was complete failure in experimental group.There were two venous compromise and one artery compromise in control group,and one of the venous compromise was a complete failure.Conclusions The isometric double notches end to end microvascular anastomosis proved successful and clinically feasible with advantages of fixed-point accuracy,time-saving and high patency rate.