复合组织瓣修复静脉功能障碍患者组织缺损研究进展.docVIP

复合组织瓣修复静脉功能障碍患者组织缺损研究进展 　　[摘要] 皮瓣常常被显微外科用于修复创面，皮瓣成活的关键主要取决于皮瓣供区内的血液循环是否能够重新建立起来。对于正常人的组织缺损，皮瓣移植的成活率相对较高，但对于一部分本身静脉血管功能即存在功能障碍的患者，皮瓣移植成活难度较大，为此类患者探索出能够最大程度恢复肢体功能的手术方式，从而降低其病残率，是当今骨科临床工作难题之一。本文对复合组织瓣修复静脉功能障碍患者组织缺损的研究进展进行探讨分析，虽然对于存在静脉功能障碍的患者，皮瓣移植无法早期建立生理性血皮瓣循环系统，但是通过动静脉化皮瓣的研究，为达到减少皮瓣张力，使得部分不能回流的组织液及血液直接外渗，从而能够避免皮瓣张力过大而导致的局部皮瓣移植区水肿加重及血管中微血栓的形成，必要时为了保证皮瓣能够存活，可以通过输血来达到这一目的，而对于存在静脉功能障碍但必须行皮瓣修复手术的患者，这不失为可行的手术方式。 　　[关键词] 静脉功能障碍；复合组织皮瓣；组织缺损；研究进展 　　[中图分类号] R543.6 [文献标识码] A [文章编号] 1673-7210（2018）03（a）-0044-04 　　[Abstract] Flap is often used to repair tissue， the key to the survival of the flap depends on whether the blood circulation in the flaps can be reestablished. For normal tissue defects， the survival rate of flap transplantation was relatively high， but for some patients with functional impairment of venous vascular function， it is difficult to transplant the flap. It is one of the difficult clinical problems in orthopedics to explore the surgical method to maximize the limb function and reduce the disability rate. In this paper， the progress of composite tissue flap for repairing tissue defects in patients with venous dysfunction was discussed， although for patients with venous dysfunction the flap was not able to establish the physiological blood flaps in the early stage， but through the study of arteriovenous flap， to reduce the tension of skin flap， making the part cannot backflow of tissue fluid and blood extravasation directly， thus can avoid excessive local flap transplantation area edema aggravated and micro thrombosis in blood vessel caused by the flap tension. If necessary， it can through a blood transfusion to keep the flap alive. For patients with venous dysfunction but must have skin flap repair， this is a viable surgical procedure. 　　[Key words] Venous dysfunction； Composite tissue flap； Tissue defect； Research progress 　　?в凶陨淼难?液供应，包含皮肤组织的活的组织块叫做皮瓣（skin flap）。皮瓣属于外科组织瓣（surgical flap）中的一种，其主要应用于修复创面、功能重建及改善外形等方面[1-2]。而复合组织皮瓣则是指同时连带有同源血供的骨、肌腱及其他组织的皮瓣[