血栓形成倾向患者头颈部手术中小血管手术的成功：病例系列。
Successful microvascular surgery in patients with thrombophilia in head and neck surgery: a case series.
机构信息
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Cologne, 50937, Cologne, Germany.
Department of Anaesthesia and Critical Care, Donau-Isar-Klinikum, 94469, Deggendorf, Germany.
出版信息
J Med Case Rep. 2024 Feb 28;18(1):119. doi: 10.1186/s13256-024-04403-8.
BACKGROUND
In this case series, a perioperative anticoagulation protocol for microvascular head and neck surgery in patients with thrombophilia is presented. Microvascular free-flap surgery is a standard procedure in head and neck surgery with high success rates. Nevertheless, flap loss-which is most often caused by thrombosis-can occur and has far-reaching consequences, such as functional impairment, prolonged hospitalization, and increased costs. The risk of flap loss owing to thrombosis is significantly increased in patients with thrombophilia. Therefore, perioperative anticoagulation is mandatory. To date, no perioperative anticoagulation protocol exists for these high-risk patients.
CASE PRESENTATION
We present three exemplary male Caucasian patients aged 53-57 years with free flap loss owing to an underlying, hidden thrombophilia.
CONCLUSION
We present a modified anticoagulation protocol for microvascular surgery in these high-risk patients, enabling successful microsurgical reconstruction.
背景
本病例系列介绍了一种针对血栓形成倾向患者微血管头颈部手术的围手术期抗凝方案。游离皮瓣显微血管手术是头颈部手术中的一种标准程序，成功率很高。然而，皮瓣失活（通常由血栓形成引起）仍有可能发生，并会产生严重后果，如功能损害、住院时间延长和费用增加。血栓形成导致皮瓣失活的风险在血栓形成倾向患者中显著增加。因此，围手术期抗凝是必需的。迄今为止，针对这些高危患者，尚无围手术期抗凝方案。
病例介绍
我们介绍了 3 例年龄 53-57 岁的高加索男性患者，他们因潜在的隐匿性血栓形成倾向而导致游离皮瓣失活。
结论
我们为这些高危患者制定了改良的显微血管手术抗凝方案，从而成功地进行了显微外科重建。
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