摘要
目的报道显微血管吻合断耳再植5例临床经验。方法自2002—2005年,将5例完全离断的耳廓彻底清创后,顺行法再植4例,逆行法再植1例,每例均吻合了1～2条动脉和1～3条静脉,其中血管缺损共7条,缺损长度1～6cm 不等,均从前臂或手背取浅静脉移植桥接。离断耳廓在伤后6～10h 重新恢复血液供应。其中1例术后静脉危象行探查手术2次,另1例静脉危象给予放血治疗。结果 5例全部成活。术后随访至3个月～1.5年。成活耳廓外形美观,萎缩轻微,1年后色素沉着基本消退,感觉恢复接近正常。结论离断耳廓若完整无明显挫伤,均可行吻合血管的再植术,切除不健康血管移植浅静脉桥接及高质量血管吻合是预防血管危象的关键。
Objective To report replantation of amputated ear with microtechnique in 5 cases. Methods From 2002 to 2005, 5 totally amputated ears were replanted and 4 obediently, 1 retrogressively. In every case, 1-2 arteries and 1-3 veins were anastomosed. Seven vessels were detective and 1-6 cm vessels were transplanted from forearm or dorsal side of hand. Amputated ears obtained blood supply again in about 6-10 hours after injury and exploration was enforced for venous crisis in 2 cases, and bloodletting in 1 case. Results All 5 cases survived. Auricles possess perfect shape, no pigmentation, slight atrophy and perfect sensation. Conclusions Amputated ear should be replantated as long as no obvious contusion occurred, and the keys to prevent vascular crisis are cutting off unhealthy vessels, grafting superficial veins for bridging, and the high quality of vascular anastomosis.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2006年第10期740-742,共3页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
