目的

探讨口腔颌面部肿瘤根治同期血管化组织瓣修复术的麻醉处理。

方法

术前组织讨论，根据病情选择气管插管方法。 术中采取综合措施，保持麻醉过程平稳，缩短手术时间，减少出血量。

结果

本组麻醉时间410 ～1060 min，手术时间360 ～980 min。 出血量500 ～1600 ml，输血率46%，输血量（593 ± 121） ml。 患者组织瓣存活率89%，均生存出院。

结论

围手术期及早介入、多方配合，采取综合措施，才能提高此类手术患者的安全性和组织瓣存活率。

Objective

To investigate the anesthesia management of vascularized free flap reconstruction in patients with oral and maxillofacial tumors.

Methods

The preoperative consultation and evaluation were performed. The methods of tracheal intubation were chosen according to the general conditions of patients and the comprehensive measures were taken during surgery to reduce operation time and hemarrage.

Results

The anesthesia and operation time ranged from 410 to 1060 minutes and 360 to 980 minutes respectively， and the hemarrage ranged from 500 to 1600 ml. 46% of the patients underwent blood transfusion with a volumn of （593±121） ml. The anesthesia process was uneventful. After surgery 203 flaps survived without major complications. Vascular crisis was observed in 33 flaps and secondary management was performed.

Conclusions

In the perioperative period early stage intervention as well as comprehensive management during operation should be performed for the safety of anesthesia and the success of surgery.