【摘要】 目的 探讨三维显微镜在口腔颌面血管吻合术中的应用价值，为临床提供参考。方法 纳入于口腔颌面外科行游离皮瓣整复手术的87例患者进行回顾性研究，三维显微镜组30例，光学显微镜组57例。比较术中血管吻合时长、术后皮瓣成活率及医生评价得分在三维显微镜组与光学显微镜组的差异，评估手术中使用三维显微镜的可行性。结果 动脉吻合耗时三维显微镜组(26.53±3.83)min/根，光学显微镜组(24.88±2.97)min/根，三维显微镜组长于光学显微镜组，差异有统计学意义(P<0.05)。静脉吻合耗时三维显微镜组(30.68±3.51)min/根，光学显微镜组(28.70±2.91)min/根，三维显微镜组长于光学显微镜组，差异有统计学意义(P<0.05)。三维显微镜组术后皮瓣成活率(93.33%)，光学显微镜组术后皮瓣成活率(92.98%)，两者差异无统计学意义(P>0.05)。三维显微镜组在视觉疲劳、学习培训、操作难易、图像共享方面的医生评价得分高于光学显微镜组，差异有统计学意义(P<0.05)。结论 三维显微镜在手术中具有良好的可靠性与安全性，立体感强，便于教学培训等优点，能够很好应用于口腔颌面血管吻合术。更多还原

【Abstract】 Objective To investigate the application value of 3D microscope in vascular anastomosis in oral and maxillofacial surgery,to provide a reference for clinicians.Methods Eighty-seven cases of free flap reconstruction in oral and maxillofacial surgery were retrospectively included,including 30 cases in the 3D microscope group and 57 cases in the optical microscope group.The differences in intraoperative vascular anastomosis time,postoperative flap survival rate and doctor evaluation scores between the 3D microscope group and the optical microscope group were compared and statistically analyzed,and the feasibility of using three-dimensional microscope in surgery was evaluated.Results The arterial anastomosis time was(26.53±3.83) min/root in the 3D microscope group and(24.88 ± 2.97) min/root in the optical microscope group,and the difference was statistically significant(P<0.05).The venous anastomosis time was(30.68± 3.51) min/root in the three-dimensional microscope group and(28.70 ± 2.91) min/root in the optical microscope group,and the difference was statistically significant(P<0.05).There was no significant difference in the survival rate of flaps between the 3D microscope group(n = 28,93.33%) and the optical microscope group(n = 53,92.98%)(P>0.05).The doctor’s evaluation scores of visual fatigue,training and learning,operative difficulty index,image sharing in the three-dimensional microscope group were higher than those in the optical microscope group,and the differences were statistically significant(P<0.05).Conclusion 3D microscope has good reliability and safety in surgery,a strong sense of three-dimensionality,and the convenience of teaching and training.It can be well applied to vascular anastomosis in oral and maxillofacial surgery.更多还原