血管加压素在游离组织移植手术中的应用。
Vasopressor use in free tissue transfer surgery.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Oregon Health-Sciences University, Portland, OR 97239, USA.
出版信息
Otolaryngol Head Neck Surg. 2010 Feb;142(2):169-73. doi: 10.1016/j.otohns.2009.11.001.
OBJECTIVE
To document the frequency of vasopressor use in free tissue transfer surgery and to compare the incidence of flap complications and flap survival in patients receiving or not receiving intraoperative vasopressors.
STUDY DESIGN AND SETTING
Case series with chart review of free tissue transfers performed between 2004 and 2006 at a large-volume tertiary academic hospital.
RESULTS
Of 241 free flaps, 169 had data available for analysis. Flap survival was 96.5 percent. The rate of other flap complications was 29 percent. A total of 139 (82%) patients received vasopressors intraoperatively. Of these, four (2.9%) flap failures and 40 (29%) complications occurred. In the 30 (18%) patients who did not receive vasopressors, two (6.7%) flap failures and nine (30%) complications occurred. The most common reasons for flap failure were arterial thrombus (n = 3) and thrombosis of the venous pedicle (n = 3).
CONCLUSION
Intraoperative vasopressors are used more frequently than previously realized but do not appear to increase overall flap failure and the incidence of complications. Intraoperative vasopressor use in free flap surgery may not be as harmful as previously feared.
目的
记录血管加压素在游离组织移植手术中的使用频率，并比较接受和不接受术中血管加压素的患者的皮瓣并发症发生率和皮瓣存活率。
研究设计和设置
这是一项回顾性病例系列研究，对 2004 年至 2006 年间在一家大型三级学术医院进行的游离组织转移手术进行了图表回顾。
结果
在 241 例游离皮瓣中，有 169 例有数据可供分析。皮瓣存活率为 96.5%。其他皮瓣并发症的发生率为 29%。共有 139 例（82%）患者术中接受了血管加压素。其中，4 例（2.9%）皮瓣失败，40 例（29%）发生并发症。在未接受血管加压素的 30 例（18%）患者中，2 例（6.7%）皮瓣失败，9 例（30%）发生并发症。皮瓣失败的最常见原因是动脉血栓形成（n=3）和静脉蒂血栓形成（n=3）。
结论
术中血管加压素的使用比以前认识到的更为频繁，但似乎并未增加总体皮瓣失败和并发症的发生率。游离皮瓣手术中术中使用血管加压素可能不像以前担心的那样有害。
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