| Part one The application value of color Doppler ultrasound in the designof the supraclavicular artery island flapObjective: 16 cases in accordance with the inclusion criteria were selected as the subjects.Color Doppler ultrasound is used to exaimin the vascular in the donor site before the supraclavicular artery island flap(SCAIF)transplantation in order to understand the shape and hemodynamic parameters of the supraclavicular artery and the transverse carotid artery.It provides help for the rational design about the supraclavicular artery island flap,such as the blood supply and the area of the flaps to be harvested,and evaluates the value of color Doppler ultrasound in the detection o before the supraclavicular artery island flap transplantation.Methods:Color Doppler ultrasound was used to detect the hemodynamic parameters such as the location,stroke and the diameter and peak systolic velocity(PSV)of bilatera supraclavicular artery and the transverse carotid 16 subjects.Hemodynamic quantitative analysis was performed to evaluate the quality and availability of blood vessels.The data were analyzed by SPSS25.0 software.The difference was statistically significant at P<0.05.Result:Color Doppler ultrasound clearly demonstrated the presence of both supraclavicular and transverse cervical arteries on both sides of the 16 subjects.The rate of display was 100%.21(66%)transverse carotid arteries were made from the thyroid axis,and 11(34%)transverse carotid arteries originated directly from the subclavian artery.The bilateral supraclavicular arteries of the 16 subjects were all transmitted from the superficial branch of the transverse carotid artery.The supraclavicular artery crossed the superficial side of the trapezius muscle and the acromial side of the collarbone and walked the shallow side of the deltoid fascia.No abnormalities such as thromboembolism and atheromatous plaque formation were found in the blood vessels examined.The average length of supraclavicular artery was 3.85±0.25 cm,left 3.87±0.28 cm,and right 3.84±0.23cm;the mean diameter of the starting diameter was 1.17±0.09 mm,left 1.19±0.09 mm,and right 1.16±0.08mm;the mean peak systolic velocity(PSV)is 17.01±2.46cm/s,the left side is 16.73±2.74cm/s,and the right side is 17.29±2.21cm/s.The average length of the transverse carotid artery was 4.30±0.43 cm,left 4.28±0.42 cm,and right 4.32±0.45 cm,the mean diameter of the starting diameter was 2.38±0.26 mm,left 2.40±0.27 mm,and right 2.36±0.25 mm The mean peak systolic velocity(PSV)was 63.48±9.30cm/s,the left side was 62.79±9.37cm/s,and the right side was 64.17±9.48cm/s.Part two The clinical application of the supraclavicular artery islandflap in repairing oral and maxillofacial soft tissue defectsObjective:To analyze the reliability of the clinical application of SCAIF in repairing the soft tissue defects of the oral and maxillofacial region,and to evaluate the effect of the repair and reconstruction.Methods:5 cases of tongue cancer and buccal cancer were selected from June 2016 to August 2017 admitted to the Department of Stomatology,the fourth hospital of Hebei Medical University,including 2 males and 3 females,aged 37-69 years,the median age was 58 years,they were given preoperative color Doppler ultrasound detection of the supraclavicular artery and the transverse cervical artery,SCAIF was used to repair the soft tissue defect at the same time.The survival rate of the flap,the function of the reconstruction area,and the donor site were followedup.Thecomplications and recover status were evaluated to evaluate the clinical effect.The survival rate was assessed by using the fourth edition of the University of Washington Quality of Life Questionnaire(UW-QOL)in March and June.Qualityof Life.Follow-up was performed to observe flap survival,reconstructed regional function,complications of donor site,and recovery.The clinical effects were evaluated.The fourth edition of the University of Washington Quality of Life Questionnaire(UW-QOL)was used to assess the quality of life at 1 month,3 months,and 6 months after surgery.Results:1.Among the 5 patients,4 flaps survived and healed well,1 case of fap with minimal partial necrosis,1 cases of donor site wound dehiscencepartly.There were no deaths and local recurrences during the follow-up period.The reconstruction of the affected area was good,and some of the speech and swallowing functions recovered.Shoulder donor area concealed,shoulder function movement unaffected ulder function is not affected.2.The average UW-QOL questionnaire score was 582.00±89.36 points in 1 month after operation,and 837.00±113.55 points in 3months afteroperation.The quality of life was good after 3 months.The average UW-QOL questionnaire score was 985.00±83.14;The quality of life 3 months after the operation was better than that of 1 after the operation,the quality of life at 6 months after surgery was significantly higher than that at 3 months after surgery.Conclusions:1.Using color Doppler ultrasound to exaimin the location,stroke and the diameter and peak systolic velocity(PSV)of the supraclavicular artery and the transverse carotid artery that is real and effective,and can evaluate the vascular quality accurately,that provides accurate and valuable imaging evidence for the design of the supraclavicular artery island flap.2.SCAIF has a good effect on postoperative soft tissue defect of oral and maxillofacial malignant tumors.Postoperative patients have high quality of life,simple flap preparation,less trauma,and fewer complications in the donor site.It is an ideal repair tissue for oral and maxillofacialsoft tissue defects. |
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