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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/OL]. 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/OL]. 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
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