摘要
目的 探讨自体下颌下腺移植术中显微外科相关问题。 方法 回顾性总结 7例下颌下腺移植术中供区受区血管的特点、下颌下腺导管的处理以及显微外科技术应用特点。 结果 第 1例出现静脉回流障碍 ,一部分腺体坏死 ;其余 6例血液循环好 ,腺体存活 ;所有 7例的颞浅静脉细小 ,血管壁薄 ,管径截面积与下颌下腺静脉相差 3～ 5倍 ,吻合难度大 ;7例中 6例用鱼嘴状吻合口 ,1例对管径大的静脉做缩窄缝合解决了口径不匹配问题 ;6例预先作颞部皮肤扩张以扩大受区的容量 ,这对维持下颌下腺移植术后的正常血液循环有重要作用。 结论 下颌下腺静脉和颞浅静脉的正确处理和吻合质量是手术的难点和成功的关键。
Objective To discuss some topics on microsurgical techniques related to free submandibular gland autologus. Method Seven cases of submandibular glands autologus were reviewed which including the characteristics of blood vessel both in donor and recipient area,the management of Wharton duct and the application of microsurgical techniques in the operation. Results The first case presented venous obstruction with partial necrosis of submandibular gland.The rest six cases totally survived with good circulation.The superficial temporal vein showed small in caliber and thin blood wall.The transverse section of gland vein and that of recipient are differ in 3～5 times.It is of great difficulties to anastomose two veins in great difference size.To solve the problem,the caliber of six cases was enlarged in the superficial temporal vein by 'fish mouse style'.The caliber of rest one was reduced by sewing a potion of vein of the gland.The skin of recipient in temporal region was expanded by tissue expander in six cases before autologus.After the skin expanded,the recipient skin was loosening enough to meet the need for gland transfer. Conclusion Correct management of vein and high quality anastomosis are key to successful vascularized submandibular gland autologous.
出处
《中华显微外科杂志》
CSCD
北大核心
2004年第3期180-182,共3页
Chinese Journal of Microsurgery
