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  本文選題：游離 + 股前外側(cè)皮瓣�。� 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的 總結(jié)我組游離股前外側(cè)皮瓣手術(shù)，探討驗證更加合理的術(shù)中處理方式。 方法 搜集整理我組在2013年10月-2014年6月期間所完成的37例游離股前外側(cè)皮瓣手術(shù)，對成活情況、探查因素與術(shù)中各類因素進(jìn)行統(tǒng)計分析，研究其之間的關(guān)聯(lián)性。 結(jié)果 本組37例病例中，血管吻合方法(共76例)：端端吻合組通暢例數(shù)70例，血栓形成3例;端側(cè)吻合組對應(yīng)數(shù)據(jù)為2例，0例；靜脈移植1例，1例通暢。統(tǒng)計分析后P=0.196，無統(tǒng)計學(xué)差異。皮瓣血管蒂夾閉情況(共33例)：夾閉血管蒂組通暢3例，血栓形成0例；未夾閉血管蒂組通暢26例，血栓形成4例。統(tǒng)計分析P=0.570，無統(tǒng)計學(xué)差異。吻合口沖洗液成分(共37例)：肝素加生理鹽水組通暢7例，血栓形成0例；生理鹽水組通暢26例，血栓形成4例。統(tǒng)計分析P=0.570，組間無顯著性差異。術(shù)中吻合口出現(xiàn)纖維蛋白(37例)：出現(xiàn)纖維蛋白組血管通暢0例，血栓形成4例；未出現(xiàn)纖維蛋白血管組通暢33例，血栓形成0例。統(tǒng)計分析P＜0.05，存在統(tǒng)計學(xué)差異。本次研究組皮瓣術(shù)后探查率8.11%,符合國際標(biāo)準(zhǔn)9.9%;皮瓣術(shù)后14天成活率91.89%。探查成功率為0，與皮瓣探查時機(jī)過晚有關(guān)。1例術(shù)后17天出現(xiàn)遲發(fā)性壞死 結(jié)論 本次研究結(jié)果表明，血管吻合方法與皮瓣術(shù)后通暢率無相關(guān)性，但端側(cè)吻合及靜脈移植技術(shù)仍是減少供區(qū)血管等損傷、處理術(shù)中供受區(qū)矛盾等棘手問題的關(guān)鍵技術(shù)。是否夾閉血管斷端及是否應(yīng)用肝素鹽水對皮瓣術(shù)后探查率無顯著影響。術(shù)中血管吻合口出現(xiàn)纖維蛋白與術(shù)后皮瓣探查率密切相關(guān)。此時處理方法應(yīng)是全身應(yīng)用肝素，，以對抗血液中的凝血活酶。
[Abstract]:Purpose To summarize the operation of free anterolateral thigh flap in our group and to discuss the more reasonable intraoperative management. Method 37 cases of free anterolateral femoral flap from October 2013 to June 2014 were collected and analyzed. Result Among the 37 cases, vascular anastomosis was performed in 76 cases (70 cases in end-to-end anastomosis group, 3 cases in thrombus formation, 2 cases in end-to-side anastomosis group and 1 case in vein transplantation group). After statistical analysis, there was no statistical difference (P < 0. 196). The vascular pedicle occlusion of the flap (33 cases) included 3 cases of patency and 0 cases of thrombosis in clipping pedicle group, 26 cases of unclipped vascular pedicle group and 4 cases of thrombus formation. There was no statistical difference between the two groups. The composition of anastomotic flushing fluid (37 cases): heparin + normal saline group (7 cases), thrombus formation (0 cases), saline group (26 cases) patency, thrombosis (4 cases). Statistical analysis showed that there was no significant difference between the two groups. There were 37 cases of fibrin fibronectasis in the anastomotic stoma, 0 cases in fibrin group, 4 cases in thrombus formation, 33 cases in fibrin group and 0 case in thrombus formation. Statistical analysis P < 0.05, there was a statistical difference. The exploratory rate of the skin flap in the study group was 8.11, which was in line with the international standard of 9.9.The survival rate of the flap was 91.8914 days after operation. The successful rate of exploration was 0. 1 cases had delayed necrosis 17 days after operation. Conclusion The results showed that there was no correlation between vascular anastomosis and patency rate after flap operation, but end-to-side anastomosis and vein transplantation were still the key techniques to reduce the injury of donor vessels and to deal with the intractable problems such as contradiction of donor area during operation. There was no significant effect on the exploration rate after flap operation by clamping the end of the vessel and using heparin saline. The appearance of fibrin in vascular anastomosis during operation is closely related to the exploration rate of skin flap after operation. Heparin should be used throughout the body to combat thromboplastin in the blood.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R622

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本文編號：1798697