头颈部重建术中抗血栓药物的围手术期管理-137 例患者的回顾性分析。
Perioperative management of antithrombotic medication in head and neck reconstruction-a retrospective analysis of 137 patients.
机构信息
Department of Otolaryngology and Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany.
出版信息
Am J Otolaryngol. 2012 Nov-Dec;33(6):693-6. doi: 10.1016/j.amjoto.2012.05.008. Epub 2012 Jul 9.
PURPOSE
Various protocols exist to prevent thrombosis after free flap surgery in the head and neck. This study reviews the outcome and incidence of perioperative complications in patients undergoing head and neck reconstruction, simply using subcutaneous low-molecular-weight heparin.
MATERIALS AND METHODS
A total of 137 free tissue transfers performed between 2007 and 2010 were reviewed. All patients received a general thrombosis prophylaxis with subcutaneous low-molecular-weight enoxaparin. No aspirin, dextran, or additional antithrombotic medication was administered.
RESULTS
Overall flap survival was 97.1%. A total of 3 complete and 1 partial flap loss occurred, all due to venous thrombosis. Five cases of venous congestion were successfully revised.
CONCLUSION
The free flap survival rate using simple subcutaneous heparin seems to be equivalent to other management regimens. Therefore, we suggest that no additional antithrombotic treatment is needed for patients who undergo head and neck reconstruction with free tissue transfer.
目的
各种方案可用于预防头颈部游离皮瓣手术后的血栓形成。本研究回顾了单纯使用皮下低分子肝素预防血栓的情况下，行头颈部重建术患者的围手术期并发症的发生情况和转归。
材料和方法
回顾了 2007 年至 2010 年间进行的 137 例游离组织转移手术。所有患者均接受皮下注射低分子肝素进行全身血栓预防。未给予阿司匹林、右旋糖酐或其他抗凝药物。
结果
总的皮瓣存活率为 97.1%。共发生 3 例完全和 1 例部分皮瓣坏死，均因静脉血栓形成所致。5 例静脉淤血患者经成功修正。
结论
使用单纯皮下肝素的游离皮瓣存活率似乎与其他治疗方案相当。因此，我们建议对于接受游离组织移植行头颈部重建的患者，无需进行其他抗凝治疗。
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