临床口腔医学杂志2016，Vol.32Issue(11)：681-683,684,4.DOI:10.3969/j.issn.1003-1634.2016.11.013
头颈缺损游离皮瓣修复后的皮瓣坏死因素分析
Analysis of the risk factors of free flaps necrosis used for reconstruction of head-neck defects
摘要
Abstract
Objective:To analyze the causes of the vascular crisis and necrosis of free flaps used for reconstruction of defects following head and neck cancer resection and the managements of these issues.Methods:The clinical characteristics (age,smoking,obesity,diabetes mellitus,hypertension,preoperative radiotherapy,anastomosed vein number and surgeon’ s experience) of 680 cases head-neck tumors patients who underwent free flaps reconstruction in our hospital from February, 2009 to July,2015 were retrospectively analyzed.The one-factor analysis and a logistic regression model were used to identify key risk factors of vascular crisis and necrosis.Results:Among the 680 transferred flaps,644 cases survived and 36 cases (8.53%) showed necrosis,the overall survival rate was 94.70%.58 flap compromises due to vascular crisis were identified and 22 flaps were salvaged completely after exploration.In multivariate analysis,smoking,obesity,preoperative radiotherapy, anastomosed vein number and surgeon’s experience(all P<0.05),rather than age,diabetes and hypertension(P>0.05) were the independent risk factors of skin flap necrosis.Two-vein anastomosis had a higher success rate than one-vein anasto-mosis(P<0.05).Conclusion:Early detection,re-exploration,and effective handling of the flap crisis increase the rate of flap salvage tremendously.Smoking,obesity,preoperative radiotherapy,anastomosed vein number and surgeon’ s experience are the key risk factors of free flap crisis.Diabetes mellitus,elderly patients and hypertension are not the contraindications for free flap reconstruction of head-neck defects.关键词
游离皮瓣/头颈缺损/血管危象/坏死/危险因素Key words
Free flap/Head-neck defect/Vascular crisis/Necrosis/Risk factor分类
医药卫生引用本文复制引用
余志刚,马壮,黄江..头颈缺损游离皮瓣修复后的皮瓣坏死因素分析[J].临床口腔医学杂志,2016,32(11):681-683,684,4.基金项目
株洲市科技局科研资助项目 （）
