Kim Eun Key, Lee Sang Shin
Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
J Craniofac Surg. 2013 May;24(3):e255-6. doi: 10.1097/SCS.0b013e318287d17a.
Several studies have reported on the incidence, risk factors, and clinical presentation of internal jugular vein thrombosis (IJVT). The impact of IJVT could be critical in patients who undergo microvascular head and neck reconstruction. In our current study, a case of IJVT following free flap soft palate reconstruction is presented, in which 2 veins of radial forearm flap were draining into the IJV with a blind cephalic end. Thrombosis occurred at the sixth postoperative day when the patient's hemodynamic status changed after discontinuation of cardiac inotropics and vasopressors. The pathophysiology as well as the clinical significance of IJVT for microvascular head and neck reconstruction is discussed with focus on the selection of the recipient vein in free flap surgery.
多项研究报告了颈内静脉血栓形成（IJVT）的发病率、危险因素及临床表现。IJVT对接受微血管头颈部重建手术的患者可能产生重大影响。在我们当前的研究中，报告了1例游离皮瓣软腭重建术后发生IJVT的病例，其中桡侧前臂皮瓣的2条静脉汇入颈内静脉，头端呈盲端。术后第6天，患者停用心脏正性肌力药物和血管升压药后血流动力学状态发生变化，此时发生了血栓形成。本文讨论了IJVT在微血管头颈部重建中的病理生理学及临床意义，重点关注游离皮瓣手术中受区静脉的选择。
