临床医学论文-皮瓣血管危象的临床表现及其处理方法.pdfVIP

临床医学论文-皮瓣血管危象的临床表现及其处理方法 【摘要】 目的 探讨皮瓣血管危象的各种临床表现以及皮瓣血管危象的针 对性处理方法。方法 观察 21 例皮瓣转移术后出现皮瓣血管危象的临床表现, 分 析产生血管危象的原因,并针对产生血管危象的不同原因采取不同的措施进行 处 理,以挽救皮瓣的成活。结果 21 例中,动脉危象 8 例,主要表现为皮瓣颜色苍 白、皮瓣发冷、毛细血管充盈反应迟钝或消失;静脉危象 13 例,主要表现皮瓣 发暗、水肿、起水泡。针对不同的原因,采取了针对性的抢救措施。20 例皮瓣 血运恢复、皮瓣最终成活;1例出现皮瓣远端坏死。结论 血管痉挛、蒂部受 压、 皮瓣下血肿形成是造成血管危象的主要原因,只有采取针对不同病因的处理措 施, 才可以保证皮瓣的成活;临床中也应注意针对以上原因进行血管危象的预防。 【关键词 】 皮瓣; 血管危象; 处理 【Abstract】 Objective To explore varied clinical manifestation and different therapeutic methods about crises of blood-circulation in skin flap. Methods The clinical manifestation were observed on 21 cases of crises of blood-circulation after skin flap grafted, the cause of crises were analysed, the different therapeutic methods were utilized to aim at the varied cause of disease in order to rescue skin flap. Results In 21 cases, 8cases were crises of artery blood supply,the main manifestations were that capillary hyperemia reaction delay or vanish, besides the skin flap become pallor and cold;13 cases were crises of venous return,the main manifestations were that skin flap become dark,hydropic, and get blister.the different therapeutic methods were utilized to aim at the varied cause of disease. 20cases recovered blood-circulation and finally survive; 1 case arised necroseis in tip of skin flap. Conclusion Leading to crises of blood-circalation,the cause are vasospasm, base of skin flap being extruded, and hematoma being formed under skin flap, only can the skin flap survive that different therapeutic methods were utilized to aim at the varied cause of disease. It should be taken serioursly to prevent crises of blood-circulation countering the above- mentioned cause. 【Key words】 skin flap; crisis of blood-circulation; therapeutic methods 皮瓣转移术后,皮瓣血管危象是影响皮瓣生存的最为严重的并发症,若处理 失当,将导致皮瓣坏死而致手术失败,只有针对引起皮瓣血管危象的原因,采取 针对性的措施予以补救,才可能化险为夷。2005 年 6 月,2007 年 3 月间,笔者 共处理皮瓣血管危象 21 例,现分析如下。 1 资料与方法