断耳再植的临床治疗体会
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摘要
目的报道应用显微外科吻合血管治疗5例耳廓离断伤的临床体会。方法 2011年6月～2016年6月,对5例患者的离断耳廓,行急诊清创显微外科吻合血管,离断组织伤后3～8 h,均手术成功重建供血,术后按再植常规给予"三抗"及补液等治疗。结果 4例再植耳廓完全成活,1例因血供障碍坏死,4例术后随访至1年,耳廓外观功能良好、有轻度萎缩及色素沉着,并恢复部分感触觉,冬天无冻疮出现。结论采用显微外科吻合血管的方法治疗耳廓离断伤,术后恢复效果良好。
Objective To report the clinical experience of 5 cases of auricle severed injury treated with microsurgical anastomosis vessel. Methods From June 2011 to June 2016, 5 patients were treated with emergency debridement and microsurgical anastomosis,and 3～8 h after the severed tissue. All the patients were successfully reconstructed and supplied with blood. After operation, they were given "three anti" and fluid replacement therapy. Results 4 cases of replanted ears survived completely, 1 case was necrosis due to blood supply disorder, 4 cases were followed up to 1 years after operation, the auricular appearance function was good, slight atrophy and pigmentation, and part of sense touch was restored, and there was no chilblain in winter. Conclusion The method of microsurgical anastomosis of blood vessels is used to treat the injury of the auricle, and the recovery effect is good after the operation.
Objective To report the clinical experience of 5 cases of auricle severed injury treated with microsurgical anastomosis vessel. Methods From June 2011 to June 2016, 5 patients were treated with emergency debridement and microsurgical anastomosis,and 3～8 h after the severed tissue. All the patients were successfully reconstructed and supplied with blood. After operation, they were given "three anti" and fluid replacement therapy. Results 4 cases of replanted ears survived completely, 1 case was necrosis due to blood supply disorder, 4 cases were followed up to 1 years after operation, the auricular appearance function was good, slight atrophy and pigmentation, and part of sense touch was restored, and there was no chilblain in winter. Conclusion The method of microsurgical anastomosis of blood vessels is used to treat the injury of the auricle, and the recovery effect is good after the operation.
引文
1于子龙,韩德民,戴海江,等.显微血管吻合断耳再植研究进展[J].国外医学(耳鼻咽喉科学分册), 2003,27(3):130-133.
2 周安梁,刘京利.断耳再植4例[J].中国中西医结合耳鼻咽喉科杂志,2011,19(6):449-435.
3 孙文海,王增涛,朱小雷,等.显微吻合血管的断耳再植[J].中华耳鼻咽喉头颈外科杂志,2006,41(10):740-742.
4 齐向东,赵卉,马立敏,等.耳郭形态结构的显微应用解剖[J].中华显微外科杂志,2014,37(2):157-160.
5 陈辉,施洪,甄泽年,等.耳廓掀翻入路的显微解剖与临床应用[J].中国临床解剖学杂志,2006,24(3):338-340.
6 杨大平,韩雪峰,郭铁芳.耳后皮瓣血管的显微外科解剖学基础[J].中国临床解剖学杂志,2002,20(3):166-168.
7 何叔宾,吴君,黄运永,等.吻合血管的断耳再植术[J].中华整形外科杂志,2015,31(5):337-339.
8 李连楚.吻合耳后动脉下耳支的断耳再植[J].中华整形外科杂志,2014,30(3):227-228.
9 陆向阳,赵立宗,苏博义,等.耳郭上2/3完全离断再植成功一例[J].中华显微外科杂志,2014,37(3):312.
10 李士民,刘林嶓,周树萍,等.耳廓完全离断再植手术八例[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):677-679.
11 蒋良福,周飞亚,杨景全,等.耳廓损伤显微再植的临床体会[J].中华整形外科杂志,2013,29(3):221-222.
2 周安梁,刘京利.断耳再植4例[J].中国中西医结合耳鼻咽喉科杂志,2011,19(6):449-435.
3 孙文海,王增涛,朱小雷,等.显微吻合血管的断耳再植[J].中华耳鼻咽喉头颈外科杂志,2006,41(10):740-742.
4 齐向东,赵卉,马立敏,等.耳郭形态结构的显微应用解剖[J].中华显微外科杂志,2014,37(2):157-160.
5 陈辉,施洪,甄泽年,等.耳廓掀翻入路的显微解剖与临床应用[J].中国临床解剖学杂志,2006,24(3):338-340.
6 杨大平,韩雪峰,郭铁芳.耳后皮瓣血管的显微外科解剖学基础[J].中国临床解剖学杂志,2002,20(3):166-168.
7 何叔宾,吴君,黄运永,等.吻合血管的断耳再植术[J].中华整形外科杂志,2015,31(5):337-339.
8 李连楚.吻合耳后动脉下耳支的断耳再植[J].中华整形外科杂志,2014,30(3):227-228.
9 陆向阳,赵立宗,苏博义,等.耳郭上2/3完全离断再植成功一例[J].中华显微外科杂志,2014,37(3):312.
10 李士民,刘林嶓,周树萍,等.耳廓完全离断再植手术八例[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):677-679.
11 蒋良福,周飞亚,杨景全,等.耳廓损伤显微再植的临床体会[J].中华整形外科杂志,2013,29(3):221-222.