切换至 "中华医学电子期刊资源库"

中华口腔医学研究杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 118 -121. doi: 10.3877/cma.j.issn.1674-1366.2018.02.008

所属专题: 文献

临床研究

面动脉切断后近、远心端动脉压力的测定和意义
严凌健1, 赵小朋1, 穆巴拉克1, 吴宇翎1, 麦潋曦1, 潘朝斌1,()   
  1. 1. 510120 广州,中山大学孙逸仙纪念医院口腔颌面外科
  • 收稿日期:2017-11-14 出版日期:2018-04-01
  • 通信作者: 潘朝斌

The mesurement and significance of blood pressure of the retrograde and the anterograde flow in the facial artery

Lingjian Yan1, Xiaopeng Zhao1, Mashrah Mubarak1, Yuling Wu1, Lianxi Mai1, Chaobin Pan1,()   

  1. 1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hosipital, Sun Yat-sen University, Guangzhou 510120, China
  • Received:2017-11-14 Published:2018-04-01
  • Corresponding author: Chaobin Pan
  • About author:
    Corresponding author:Pan Chaobin,Email:
引用本文:

严凌健, 赵小朋, 穆巴拉克, 吴宇翎, 麦潋曦, 潘朝斌. 面动脉切断后近、远心端动脉压力的测定和意义[J]. 中华口腔医学研究杂志(电子版), 2018, 12(02): 118-121.

Lingjian Yan, Xiaopeng Zhao, Mashrah Mubarak, Yuling Wu, Lianxi Mai, Chaobin Pan. The mesurement and significance of blood pressure of the retrograde and the anterograde flow in the facial artery[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2018, 12(02): 118-121.

目的

研究面动脉切断后近、远心端动脉是否具有恒定的血压,其远心端动脉血压能否为皮瓣的存活提供足够的血流基础。

方法

选择2017年3—7月中山大学孙逸仙纪念医院口腔癌患者25例(临床检查均已排除颈部淋巴结转移),所有患者术前告知此实验内容并同意接受此实验。于下颌骨下缘解剖充分暴露面动脉,并结扎沿途分支。于面动脉远心端距离下颌骨下缘下方约1 cm处剪断面动脉,置入动脉导针并连接动脉血压换能器,分别记录数值。此后结扎下唇动脉,观察血压变化情况,采用t检验评价面动脉近、远心端收缩压及舒张压两组数据间的差异性。

结果

远心端收缩压平均值为(88.00 ± 17.46)mmHg(1 mmHg= 0.133 kPa),远心端舒张压平均值为(60.33 ± 7.49)mmHg,近心端收缩压平均值为(113.36 ± 21.22)mmHg,近心端舒张压平均值为(68.80 ± 11.63)mmHg。远心端收缩压为近心端77.68%,远心端舒张压为近心端88.43%,近、远心端收缩压(t= 10.210,P<0.001)及近、远心端舒张压(t= 6.643,P<0.001),两者差异均具有统计学意义。结扎下唇后面动脉远心端血压无明显波动。

结论

面动脉远心端的压力较近心端虽有所下降,但仍具有足够血压能够为组织瓣存活提供良好的血运。

Objective

To study whether the proximal and distal facial artery have a constant blood pressure after the facial artery is cut and whether the retrograde flow of the distal, paramandibular part of the facial artery would provide sufficient pressure to perfuse the flap for survival.

Methods

We seleted 25 oral squamous cell carcinoma cases from Mar. 2017 to July 2017 treated in Sun Yet-san Memorial Hospital (lymphatic metastasis was excluded) . All patients were informed before surgery and agreed to accept the experiment. We dissected the facial artery and occluded the branch of it, the facial artery was occluded with two vessel clamps at the level of the mandible and prepared to allow for insertion of a standard intravenous polyethylene. The tube was connected to a pressure transducer. Arterial pressure and the pulsatile wave of the facial artery were recorded, and then with the ligation of the lower lip artery. The blood pressure of retrograde and the anterograde in facial artery was recorded and analyzed.

Results

The mean systolic blood pressure in the distal facial atery was (88.00 ± 17.46) mmHg (1 mmHg= 0.133 kPa) . The mean distolic blood pressure in the distal facial atery was (60.33 ± 7.49) mmHg. The mean systolic blood pressure in the proximal facial atery was (113.36 ± 21.22) mmHg. The mean distolic blood pressure in the proximal facial atery was (68.80 ± 11.63) mmHg. Systolic blood pressure arterial pressure in the distal facial artery with retrograde flow was 77.68% of the anterograde arterial pressure. Diastolic blood pressure arterial pressure in the distal facial artery with retrograde flow was 88.43% of the anterograde arterial pressure. The systolic blood pressure in the distal facial atery was compared with the systolic blood pressure in the proximal facial atery (t= 10.210, P<0.001) . The mean distolic blood pressure in the distal facial atery was compared with the distolic blood pressure in the proximal facial atery (t= 6.643, P<0.001) . After ligation of the lower lip artery, the blood pressure of the retrograde and the anterograde showed no significant fluctuations.

Conclusions

Although the retrograde blood pressure in the facial artery descend compared to the anterograde, there is no significant difference between them. Thus, there is a good blood flow basis for retrograde facial artery, which could provide good blood supply for tissue flap survival.

图1 游离皮瓣移植修复术区缺损手术分别在面动脉近、远心端置入动脉导针
图2 游离皮瓣移植修复术区缺损手术暂时阻断下唇动脉(箭头)
图3 口腔癌游离皮瓣移植术患者面动脉近、远心端血压均值比较
[1]
Wang JG,Chen WL,Ye HS,et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation[J]. J Craniomaxillofac Surg,2011,39(7):499-502.
[2]
Chen WL,Ye JT,Yang ZH,et al. Reverse facial artery-submental artery mandibular osteomuscular flap for the reconstruction of maxillary defects following the removal of benign tumors[J]. Head Neck,2009,31(6):725-731.
[3]
Ferrari S,Ferri A,Bianchi B,et al. Head and neck reconstruction using the superiorly based reversed-flow facial artery myomucosal flap[J]. J Oral Maxillofac Surg,2015,73(5):1008-1015.
[4]
Hölzle F,Hohlweg-Majert B,Kesting MR,et al. Reverse flow facial artery as recipient vessel for perforator flaps[J]. Microsurgery,2009,29(6):437-442.
[5]
Camuzard O,Foissac R,Georgiou C,et al. Facial artery perforator flap for reconstruction of perinasal defects:An anatomical study and clinical application[J]. J Craniomaxillofac Surg,2015,43(10):2057-2065.
[6]
Zhou WN,Wan LZ,Zhang P,et al. Anatomical Study and Clinical Application of Facial Artery Perforator Flaps in Intraoral Reconstruction:Focusing on Venous System[J]. J Oral Maxillofac Surg,2017,75(3):649.e1-649.e10.
[7]
Wolff KD,Hölzle F,Nolte D. Perforator flaps from the lateral lower leg for intraoral reconstruction[J]. Plast Reconstr Surg,2004,113(1):107-113.
[8]
赵小朋,刘军平,焦九阳,等.逆行面动脉瓣修复口腔颌面部肿瘤术后缺损12例报道[J].中国口腔颌面外科杂志,2012,10(3):227-230.
[9]
Huang SH,Wu SH,Wang WH,et al. Reversed-flow superior thyroid artery:an alternative recipient vessel in head and neck reconstruction[J]. Kaohsiung J Med Sci,2008,24(11):598-601.
[10]
Neligan PC,She-Yue H,Gullane PJ. Reverse flow as an option in microvascular recipient anastomoses[J]. Plas Reconstr Surg,1997,100(7):1780-1785,discussion 1786-1787.
[11]
Mitz V,Ricbourg B,Lassau JP. Facial branches of the facial artery in adults. Typology,variations and respective cutaneous areas[J]. Ann Chir Plast,1972,18(4):339-350.
[12]
Hwang K,Lee GI,Park HJ. Branches of the Facial Artery[J]. J Craniofac Surg,2015,26(4):1399-1402.
[13]
赵振民,李森恺,李养群,等.面动、静脉的彩色多普勒超声图像研究[J].中华整形外科杂志,2002,18(4):224-225.
[1] 李婷婷, 崔翔, 刘静, 吴鑫, 杨汐, 陈莉. 新型脐周按钮式切口在横向腹直肌肌瓣乳房重建中的应用[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 347-352.
[2] 邓华梅, 袁札根, 曾德荣, 潘珊珊, 张葆青, 欧爱华, 曹学伟. 全膝关节置换术中气压止血带应用效果与影响因素分析[J]. 中华关节外科杂志(电子版), 2023, 17(06): 788-794.
[3] 靳茜雅, 黄晓松, 谭诚, 蒋琴, 侯昉, 李瑶悦, 徐冰, 贾红慧, 刘文英. 产前他克莫司治疗对先天性膈疝大鼠病理模型肺血管重构的影响[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 428-436.
[4] 郝丽文, 王增涛, 荣凯, 侯致典, 陈超, 仇申强, 刘林峰, 张迪, 王云鹏, 钟硕. 趾增宽术在缺损手指全形再造中的应用效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 476-479.
[5] 仇申强, 王增涛, 郝丽文, 陈超, 刘林峰, 张迪. 拇手指全形再造二期整形的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 485-490.
[6] 陈永沛, 仲海燕, 陈勇, 王慜, 王倩, 邹鸣立, 袁斯明. 数字减影血管造影在腓动脉穿支皮瓣移植中的应用[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 507-510.
[7] 朴广昊, 李屹洲, 刘瑞, 赵建民, 王凌峰. 皮肤撕脱伤撕脱皮瓣活力早期评估与修复的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 528-532.
[8] 李硕, 尹希, 祁连港, 王丽, 刘宗宝. 浓缩生长因子在促进失神经皮瓣术后神经再生的应用前景[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 547-551.
[9] 张浩, 张万福, 韩飞, 佟琳, 王运帷, 李少辉, 陈阳, 曹鹏, 官浩. 游离组织瓣治疗无吻合血管或需困难吻合血管创面的临床进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 442-446.
[10] 李建美, 邓静娟, 杨倩. 两种术式联合治疗肝癌合并肝硬化门静脉高压的安全性及随访评价[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 41-44.
[11] 张其坤, 商福超, 李琪, 栗光明, 王孟龙. 联合脾切除对肝癌合并门静脉高压症患者根治性切除术后的生存获益分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 613-618.
[12] 许语阳, 吕云福, 王葆春. 乙肝后肝硬化门静脉高压症脾肿大外科治疗进展[J]. 中华肝脏外科手术学电子杂志, 2023, 12(04): 469-473.
[13] 运陌, 李茂芳, 王浩, 刘东远. 微创穿刺引流联合吡拉西坦、乌拉地尔治疗基底节区高血压性脑出血的临床研究[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 278-285.
[14] 刘政委, 仪立志, 尹夕龙, 孔文龙, 纠智松, 张文源. 锥颅血肿外引流与神经内镜手术治疗老年基底节区高血压性脑出血的疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 299-303.
[15] 王延召, 牛鹏飞, 丁长民, 高庆坤, 高兆亚, 安柯, 翟志超, 曾庆敏, 黄文生, 雷福明, 顾晋. 结直肠癌致腹壁巨大缺损的一期修补经验(附13例报告)[J]. 中华临床医师杂志(电子版), 2023, 17(05): 557-561.
阅读次数
全文


摘要