Objective:To analyze the reconstruction of oral and maxillofacial tissue defects in two different anastomosis methods of arterial end-to-end anastomosis and end-to-end arterial anastomosis of free flap.Color Doppler ultrasound was used to reconstruct the defect of oral and maxillofacial tissue by free flap transplantation.Early postoperative hemodynamic monitoring,comparing the two arterial anastomosis time,ischemia-reperfusion time,and hemodynamic changes,It provides an objective reference for the popularization and application of arterial end-to-side anastomosis in oral and maxillofacial tissue defect free flap transplantation.Methods:The clinical data of patients with oral and maxillofacial defects reconstructed with free flaps from October 2018 to December 2019 in the maxillofacial trauma orthognathic surgery of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed.According to the inclusion exclusion criteria,a total of 38 patients were included.According to the intraoperative arterial anastomosis,13 patients were included in the ESA group using arterial end-to-side anastomosis(ESA),and 25 patients were included in the EEA group using arterial end-to-end anastomosis(EEA).Statistical analysis was performed on intraoperative arterial anastomosis time,flap ischemia-reperfusion time,postoperative vascular crisis rate,flap necrosis rate due to arterial crisis,and early postoperative hemodynamic indicators.Results:The arterial anastomosis time and flap ischemia-reperfusion time in the ESA group were longer than those in the EEA group(P<0.01);but there was no statistical difference in the incidence of flap necrosis and vascularcrisis due to arterial crisis(P>0.05).The peak systolic velocities PSV and blood flow Q in the ESA group at 1 day,3 days,and 7 days after the operation were greater than those in the EEA group(P<0.05).Conclusion:In the reconstruction of oral and maxillofacial tissue defects with free skin flaps,the two arterial anastomosis methods have no significant difference in the survival rate of flaps and the incidence of vascular crisis,but the hemodynamic index ESA in the early 1-7 days after surgery better than EEA.It further confirmed the clinical practicability and reliability of ESA in repairing maxillofacial defects with free flap transplantation from the aspect of hemodynamic. |