口腔医学研究

口腔医学研究 ›› 2019, Vol. 35 ›› Issue (11): 1048-1051.DOI: 10.13701/j.cnki.kqyxyj.2019.11.010

• 口腔颌面外科学研究 • 上一篇    下一篇

任氏血管吻合法在口腔颌面部缺损修复中的应用及评价

郭丰源1, 李文强2, 许智1, 黄春明2, 胡传宇2*   

  1. 1. 华中科技大学同济医学院附属协和医院口腔颌面外科 湖北 武汉 430000;
    2. 华中科技大学同济医学院附属同济医院口腔颌面外科 湖北 武汉 430000
  • 收稿日期:2019-03-07 出版日期:2019-11-28 发布日期:2019-11-21
  • 通讯作者: 胡传宇,E-mail:hucyspace@163.com
  • 作者简介:郭丰源(1988~ ),男,湖北人,博士在读,主治医师,主要从事口腔颌面外科研究工作。
  • 基金资助:
    湖北省自然科学基金面上项目(编号:2019CFB657)

Application of Ren Anastomosis in Reconstruction of Oral and Maxillofacial Defects

GUO Fengyuan1, LI Wenqiang2, XU Zhi1, HUANG Chunming2, HU Chuanyu2*   

  1. 1. Department of Stomatology, Union Hospital,Tongji Medical College,HuaZhong University of Science and Technology,Wuhan 430000,China;
    2. Department of Stomatology, Tongji Hospital,Tongji Medical College,HuaZhong University of Science and Technology,Wuhan 430000,China
  • Received:2019-03-07 Online:2019-11-28 Published:2019-11-21

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摘要： 目的: 探讨任氏血管吻合方法在口腔颌面部缺损游离皮瓣修复中应用的可行性、有效性及其临床应用价值。方法: 收集2017年7月~2018年12月,华中科技大学同济医学院附属同济医院和华中科技大学同济医学院附属协和医院口腔颌面外科行游离皮瓣修复口腔颌面部缺损的病人116例(118块皮瓣),男97例,女19例,年龄34~71岁;实验组(50块皮瓣)和对照组(68块皮瓣),实验组的显微动脉的吻合方法为任氏血管缝合法,对照组显微动脉的吻合方法为常规的等距双定点间断缝合法,两组的显微静脉吻合方法均为常规的间断吻合法(端端吻合或端侧吻合)。结果: 实验组的动脉吻合时间为(5.6±2.1) min,对照组为(13.7±4.2) min,差异具有统计学意义(P<0.001);实验组1例动脉危象,1例静脉危象并发生皮瓣坏死,对照组动脉危象1例,静脉危象3例,其中1例动脉危象抢救失败,皮瓣坏死。结论: 任氏血管吻合法与常规血管吻合法相比可以明显缩短手术时间且操作简便,建议推广该血管吻合方法在口腔颌面部缺损修复中的应用。

关键词: 任氏血管吻合, 显微外科, 游离皮瓣, 动脉吻合, 口腔颌面部缺损

Abstract: Objective: To explore the feasibility, effectiveness, and clinical value of Ren anastomosis in oral and maxillofacial defects repair with free flaps. Methods: Between July 2017 and December 2018, 116 patients (118 flaps), including 97 males and 19 females, aged 34-71 years old, underwent free skin flap repair for oral and maxillofacial defects in departments of oral and maxillofacial surgery of Tongji hospital and Union hospital, Tongji Medical College, Huazhong University of Science and Technology. They were divided into two groups according to the arterial anastomosis method, Ren anastomosis group (50 flaps) and conventional end to end anastomosis group (68 flaps). And the venous anastomosis method of the both groups was conventional end to end or end to side anastomosis. Results: The average time of arterial anastomosis of Ren anastomosis was obviously shorter than that of control group [(5.6±2.1) minutes and (13.7±4.2) minutes]. In totally, one case of arterial crisis and one case of venous crisis following with the flap necrosis occured in Ren anastomosis group; and in the control group, one flap failed to rescue after arterial crisis and 3 flaps developed venous crisis. Conclusion: Ren vascular anastomosis method obviously reduces the operation time and simplifies operation steps compared to conventional vascular anastomosis. It was recommonded to use Ren anastomosis in the repair of oral and maxillofacial defects.

Key words: Ren anastomosis, microsurgery, free flap, artery anastomosis, oral and maxillofacial defects