目的分析游离腹部皮瓣乳房重建术后皮瓣血管危象发生的相关因素。方法收集2006年11月至2015年2月在复旦大学附属肿瘤医院乳腺外科147例接受游离腹部皮瓣乳房重建的病人资料,分析血管危象的发生和解救情况,并通过统计分析寻找血管危象的相关因素。结果 147例乳房重建中,术后共有12例(8.2%)发生血管危象,其中11例为静脉危象,1例为静脉危象合并动脉危象。最终7例(58.3%)解救成功,2例发生部分坏死,3例全部坏死,总皮瓣成功率为98.0%。手术时间与血管危象的相关度较高(OR=5.696)。结论血管危象的发生受诸多因素的影响,手术时间与其紧密相关,术者经验的积累、血管吻合器的应用等均有助于手术时间的缩短。 Objective To analyze the related factors of vascular crisis of flap after breast reconstruction of free abdominal flap. Methods From November 2006 to February 2015 in the Department of Breast Surgery, Fudan University Affiliated Tumor Hospital, 147 patients undergoing free abdominal flap reconstruction of breast reconstruction data were analyzed for the occurrence and rescue of vascular crisis, and through statistical analysis to find vascular crisis Related factors. Results In 147 cases of breast reconstruction, 12 cases (8.2%) had vascular crisis after operation. Among them, 11 cases were venous crisis and 1 case was venous crisis with arterial crisis. The final 7 cases (58.3%) were successfully rescued, 2 cases had partial necrosis, 3 cases were all necrotic, and the total flap success rate was 98.0%. The correlativity between operation time and vascular crisis was higher (OR = 5.696). Conclusion The occurrence of vascular crisis is affected by many factors, the operation time is closely related to it, the accumulation of experience of the surgeon, the application of vascular stapler and so on all contribute to the shortening of operation time.