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目的报道显微血管吻合断耳再植5例临床经验。方法自2002—2005年,将5例完全离断的耳廓彻底清创后,顺行法再植4例,逆行法再植1例,每例均吻合了1～2条动脉和1～3条静脉,其中血管缺损共7条,缺损长度1～6cm 不等,均从前臂或手背取浅静脉移植桥接。离断耳廓在伤后6～10h 重新恢复血液供应。其中1例术后静脉危象行探查手术2次,另1例静脉危象给予放血治疗。结果 5例全部成活。术后随访至3个月～1.5年。成活耳廓外形美观,萎缩轻微,1年后色素沉着基本消退,感觉恢复接近正常。结论离断耳廓若完整无明显挫伤,均可行吻合血管的再植术,切除不健康血管移植浅静脉桥接及高质量血管吻合是预防血管危象的关键。
Objective To report the clinical experience of 5 cases of replantation of severed ear with microvascular anastomosis. Methods From 2002 to 2005, five cases of complete auricle debridement were completely debrided. Four cases were replanted by paraffin method and one case was replanted by retrograde method. Each case was consistent with 1-2 arteries and 1-3 A total of seven veins, including vascular defects, length of defects ranging from 1 ~ 6cm, were taken from the forearm or superficial vein graft bridging. Breaking auricle 6 ~ 10h after injury to resume the blood supply. One case of postoperative venous crisis exploration operation 2 times, another case of venous crisis give bleeding treatment. Results 5 cases all survived. Follow-up to 3 months to 1.5 years. Survival auricle beautiful appearance, atrophy mild, a year later subsided pigmentation, feeling close to normal recovery. Conclusion If the intact auricle is intact, it is feasible to replant anastomotic vessels. The removal of unhealthy vascular graft and venous anastomosis is the key to prevent vascular crisis.