Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6, Koto-ku, Tokyo, Japan.
Microsurgery. 2010 Jul;30(5):376-9. doi: 10.1002/micr.20742.
In free tissue transfers, preventing microvascular thrombosis is the first priority to achieve a successful result. Numerous protocols exist for preventing thrombosis postoperatively. We performed continuous local intraarterial infusion of anticoagulants in 11 patients undergoing wide resection of malignant soft tissue tumors, followed by primary microvascular reconstruction in the lower limb. A catheter designed for epidural anesthesia was inserted into the femoral artery and connected to a syringe pump. A daily dose of 100 ml comprising 2,000 U of heparin and 40 microg of prostaglandin E(1) was administered by means of continuous infusion for seven consecutive days as a standard regime. There were no cases of thrombosis during the continuous local intraarterial infusion of anticoagulants. There were no serious systemic complications. Although we have described limited cases and supporting data are lacking, we feel that this procedure might be useful for microsurgical reconstruction of the lower limb.
在游离组织移植中，防止微血管血栓形成是获得成功的首要任务。有许多预防术后血栓形成的方案。我们对 11 例行恶性软组织肿瘤广泛切除术并随后进行下肢原发性微血管重建的患者进行持续局部动脉内输注抗凝剂。将用于硬膜外麻醉的导管插入股动脉，并连接到注射器泵。通过连续输注，每天给予包含 2000U 肝素和 40 微克前列腺素 E1 的 100ml 标准剂量，连续 7 天。在持续局部动脉内输注抗凝剂期间，没有发生血栓形成。没有出现严重的全身并发症。尽管我们描述了有限的病例，且缺乏支持数据，但我们认为该方法可能对下肢显微重建有用。
