胸大肌肌皮瓣坏死原因分析及预防处理体会

发布时间：2018-03-19 04:08

本文选题：外科皮瓣　切入点：坏死　出处：《中国耳鼻咽喉头颈外科》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨胸大肌肌皮瓣坏死的原因与有效预防和处理的方法。方法回顾分析我院2008年11月~2013年11月117例胸大肌肌皮瓣转移修复头颈部缺损的病例临床资料,寻找可能导致肌皮瓣坏死的原因。结果 117例胸大肌肌皮瓣修复的病例中有13例发生坏死,其中2例发生全部坏死、11例部分坏死。1例因以胸肩峰血管为血管蒂常规制备胸大肌肌皮瓣后全部坏死,1例术中操作误伤胸肩峰动脉后全部坏死;其余11例部分坏死中,7例伴有糖尿病,2例为肥胖患者,2例待修复的缺损区为大剂量放疗后。结论术前有效地处理基础疾病、术中充分认识胸大肌肌皮瓣血供以及熟练掌握胸大肌肌皮瓣制备技巧是减少胸大肌肌皮瓣坏死的重要措施。
[Abstract]:Objective to investigate the causes of pectoralis major myocutaneous flap necrosis and the effective methods of prevention and treatment. Methods the clinical data of 117 cases of head and neck defect repaired by pectoralis major myocutaneous flap from November 2008 to November 2013 were retrospectively analyzed. Results among 117 cases of pectoralis major myocutaneous flap repair, 13 cases were necrotic. All necrosis occurred in 2 cases, partial necrosis occurred in 11 cases. 1 case suffered from necrosis after pectoralis major myocutaneous flap was made by using thoracic acromitis vessel as vascular pedicle. Among the remaining 11 cases of partial necrosis, 7 cases were associated with diabetes mellitus and 2 cases were obese patients. The defect area of 2 cases to be repaired is after high dose radiotherapy. Conclusion the basic diseases can be effectively treated before operation. Understanding the blood supply of pectoralis major myocutaneous flap and mastering the preparation technique of pectoralis major myocutaneous flap are important measures to reduce the necrosis of pectoralis major myocutaneous flap.
【作者单位】：安徽医科大学第一附属医院耳鼻咽喉头颈外科;
【基金】：安徽省2015科技攻关计划项目(1501041147)
【分类号】：R730.5

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