探讨建立游离折叠皮瓣修复口腔癌洞穿缺损术后血管危象的护理与评估机制。

选择中山大学孙逸仙纪念医院2013年8月至2016年8月间收治的37例口腔恶性肿瘤患者，行游离折叠皮瓣转移修复颌面部洞穿性缺损，按血管危象预警机制标准进行护理与评估，包括口腔内外侧皮瓣颜色、质地，外侧瓣皮温为主，综合患者全身状况。凡是在评估低于标准20%以上的立即通知医生，及早对症处理。

符合入组标准口腔恶性肿瘤患者共37例，在术后0~ 3 d内出现血管危象6例。其中出现静脉血管危象患者4例、动脉危象2例。经过医护配合及时处理皮瓣得以挽救。

术后根据血管危象预警机制标准在护理工作中密切观察皮瓣及全身情况，根据患者自身基础血压、正常皮温、供区肤色的对比进行评估，及时发现及早处理皮瓣血管危象，降低不良因素的影响，及早对症处理，提高皮瓣成活率。

To explore a proper manner for the prevention and evaluation of vascular crisis, and to improve the success rate of flaps for full thickness defects in patients suffering from oral cancer.

Patients suffering from oral cancer (37 cases) during August 2013 and August 2015 underwent one stage radical surgery and reconstruction of full thickness defects with free folded flap. Flaps were observed and evaluated according to the criteria of vascular crisis prevention, including the color, density, temperature of both sides (intra/extra-oral) . Once such parameters were 20% lower than the standard, it was reported to surgeons at once and proper measures were taken.

Six cases of vascular crisis were found in no more than three days post-operation, including four cases of venous thrombosis and two cases of arterial thrombosis. All these cases recovered after proper treatment.

It is important to observe and evaluate the flap according to the criteria of vascular crisis prevention, which is of help in improving the success rate of surgery.