«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2023年5期

页码:

162-166

栏目:

出版日期:

2023-05-10

文章信息/Info

Title:

Analysis of the Related Factors of Vascular Crisis after Repair of Oral and Maxillofacial Tumors with Anterolateral Thigh Perforator Flap

文章编号:

1008-6455（2023）05-0162-05

作者:

李炜伟¹ ; 覃小荣² ; 唐小芳³ ; 潘孟雄² ; 肖 玲¹ ; 龚震宇¹

(1.桂林医学院附属医院烧伤创面修复整形外科 医学美容外科 广西 桂林 541001 ;2.桂林医学院附属医院口腔颌面外科 广西 桂 林 541001 ;3.桂林医学院附属口腔医院手术室 广西 桂林 541001 )

Author(s):

LI Weiwei¹ ; QIN Xiaorong² ; TANG Xiaofang³ ; PAN Mengxiong² ; XIAO Ling¹ ; GONG Zhenyu¹

( 1.Department of Burn,Would Repair Surgery and Plastic Surgery,Department of Aesthetic Surgery,Affi liated Hospital of Guilin Medical University, Guilin 541001, Guangxi,China; 2.Department of Oral and Maxillofacial Surgery,Affi liated Hospital of Guilin Medical University,Guilin 541001,Guangxi,China; 3.Operating Room,Affi liated Stomatological Hospital of Guilin Medical University,Guilin 541001,Guangxi,China)

关键词:

口腔颌面部肿瘤术; 股前外侧穿支皮瓣; 血管危象; 相关因素

Keywords:

oral and maxillofacial tumor surgery;  anterolateral thigh perforator fl ap;  vascular crisis;  related factors

分类号:

R739

文献标志码:

A

摘要:

目的：探讨影响口腔颌面部肿瘤术后经股前外侧穿支皮瓣修复缺损发生血管危象的相关因素。方法：回顾性分析2011 年3月-2021年3月笔者医院治疗的256例口腔颌面肿瘤术后经股前外侧穿支皮瓣修复的患者临床资料，依据患者术后是否发生 血管危象将患者分为危象组（42例）和正常组（214例）。比较两组患者的临床资料，多因素Logistic回归分析口腔颌面部 肿瘤术后经股前外侧穿支皮瓣修复患者发生血管危象的相关因素。结果：42例口腔颌面部肿瘤术后经股前外侧穿支皮瓣修复 的患者术后发生血管危象，其中28例（66.67%）发生于术后24 h内，12例（28.57%）发生于术后24～72 h，2例（4.76%）发 生于72 h后，术后发生血管危象抢救总成功率为52.38%；血管危象组患者糖尿病、空腹血糖、放疗史、吻合方式、吻合静脉 数、白蛋白、D-二聚体以及纤维蛋白原差异有统计学意义（P＜0.05）；Logistic多元回归分析结果表明糖尿病史、吻合方 式为端侧吻合、吻合静脉数＜2、白蛋白水平降低以及纤维蛋白原水平升高是影响口腔颌面部肿瘤术后经股前外侧穿支皮瓣 修复后发生血管危象的关键因素（P＜0.05）。结论：口腔颌面部肿瘤术后经股前外侧穿支皮瓣修复后患者的血管危象与吻 合方式、糖尿病、白蛋白、吻合静脉数以及纤维蛋白原有关，临床医师应根据这些危险因素，尽早识别血管危象及时处理， 降低患者发生血管危象的风险，以提高皮瓣的成活率。 [

Abstract:

Objective To explore the related factors of vascular crisis after anterolateral thigh perforator fl ap repair of oral and maxillofacial tumors. Methods From March 2011 to March 2021,the clinical data of 256 patients with oral and maxillofacial tumors treated in the author’s hospital were analyzed retrospectively. The patients were divided into crisis group (42 cases) and normal group (214 cases) according to whether the patients had vascular crisis after operation. The clinical data of the two groups of patients were compared;Multivariate Logistic regression analysis was used to analyze the related factors of vascular crisis in patients with oral and maxillofacial tumors after anterolateral thigh perforator flap repair. Results Vascular crisis occurred in 42 patients with oral and maxillofacial tumors repaired by anterolateral thigh perforator fl ap, 28 cases (66.67 %) occurred within 24 hours of surgery, 12 cases (28.57%) occurred between 24-72 hours, and 2 cases (4.76%) occurred 72 hours later. The success rate of postoperative vascular crisis was 52.38%;There were statistically signifi cant diff erences in diabetes, fasting blood glucose, history of radiotherapy, anastomosis, number of anastomosed veins, albumin, D-dimer and fi brinogen in the vascular crisis group (P ＜0.05);Multivariate Logistic regression analysis showed that diabetes, anastomotic methods of end-to-side anastomotie, number of anastomosed veins＜2, albumin and fi brinogen were independent risk factors for vascular crisis after anterolateral thigh perforator fl ap repair of oral and maxillofacial tumors (all P ＜0.05). Conclusions The vascular crisis of patients with oral and maxillofacial tumors after anterolateral thigh perforator fl ap repair is related to the anastomotic mode, diabetes, albumin, the number of anastomotic veins and fi brinogen.Based on these risk factors, clinicians should identify vascular crisis as early as possible, so as to reduce the risk of vascular crisis and improve the survival rate of the fl ap.

常用功能

更新日期/Last Update: 2023-06-20