国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (1): 124-133.doi: 10.7518/gjkq.2026205

• 综述 • 上一篇    下一篇

血管吻合术的临床应用与研究进展

王世忠(),张乐汶,李志轩,丁张帆,闫冰(),李春洁   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心四川大学华西口腔医院头颈肿瘤外科 成都 610041
  • 收稿日期:2024-12-04 修回日期:2025-06-04 出版日期:2026-01-01 发布日期:2025-12-31
  • 通讯作者: 闫冰
  • 作者简介:王世忠，学士，Email：2021151640178@stu.scu.edu.cn
  • 基金资助:
    四川省自然科学基金青年基金(2024NSFSC1590);成都市科技项目技术创新研发项目(2024-YF05-00437-SN)

Clinical application and development of vascular anastomosis

Shizhong Wang(),Lewen Zhang,Zhixuan Li,Zhangfan Ding,Bing Yan(),Chunjie Li   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-12-04 Revised:2025-06-04 Online:2026-01-01 Published:2025-12-31
  • Contact: Bing Yan
  • Supported by:
    Sichuan Provincial Natural Science Foundation Youth Fund(2024NSFSC1590);Chengdu Science and Technology Project Technology Innovation Research and Development Project(2024-YF05-00437-SN)

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摘要：

血管吻合术在口腔颌面外科、整复外科以及心血管外科等领域应用广泛。传统血管吻合术操作难度大、时间长，对术者有较高要求。近年来，新型血管吻合技术、内镜下吻合术、显微血管吻合术等技术的快速发展为临床实践提供了更多选择，同时也提高了手术效率，降低了手术风险。这些技术在微小血管吻合、组织器官修复重建以及超显微外科等领域展现出了独特优势。血管吻合新技术不仅为外科医生提供了便利，也满足了各类患者的不同需求，帮助外科医生为患者提供更优质的诊疗。本文从手工缝合技术、血管吻合辅助装置及数字化技术、新型材料吻合技术3个方面总结了血管吻合术的最新进展，旨在帮助外科医生了解血管吻合技术发展动态，为各类术式选择提供参考。

关键词: 血管吻合, 机器人手术, 显微外科, 血管假体

Abstract:

Vascular anastomosis is widely used in oral and maxillofacial surgery, plastic and reconstructive surgery, and cardiovascular surgery. Conventional vascular anastomosis is challenging and time-consuming, hence demanding for surgeons. In recent years, new vascular suture anastomosis techniques, endoscopic anastomosis, and microvascular anastomosis have provided additional choices for clinical practice, improved the efficiency of the operation, and reduced the risk of the operation. These methods have demonstrated unique advantages in microvascular anastomosis, organ reconstruction, and ultra-microsurgery. These advances not only provide increased convenience for surgeons but also meet the needs of different types of patients for enhanced therapeutic outcomes. In this review, the recent advances in the techniques of vascular anastomosis are summarized from three aspects: manual suture techniques, vascular anastomosis assistive devi-ces and digital technology, and anastomosis based on biomaterials. This review aims to help surgeons understand the deve-lopment trends of vascular anastomosis technology and provide references for the selection of surgical procedures.

Key words: vascular anastomosis, robotic surgical, microsurgery, vascular prosthesis

中图分类号: 

  • R616.2

图 1

人工缝合术操作示意图A：任氏血管吻合术；B：Y-I型血管吻合术；C：II-Y型血管吻合术；D：“多U”技术；E：“卷袖”技术。"

图 2

磁性血管吻合术A：装置结构，由2个外周的磁环与1个中间的铆钉环构成；B：磁性血管装置的使用方法与吻合过程。"

图 3

血管耦合器吻合术A：耦合器装置示意图与操作示意图；B：使用耦合器的外部装置与操作示意图。"

图 4

合成血管材料应用A：人工血管置换术操作示意图；B：可生物降解合成血管置换操作示意图，其中小图为该材料引导的新芽与自组装毛细血管吻合。"

表 1

各种血管吻合术的优点与缺点"

方法优点缺点
人工缝合术应用范围广泛，对设备仪器要求低1）手术时间长，技术要求高；2）不可吸收的缝合材料可能导致炎症、血小板聚集等问题。
内镜下吻合术侵入性小，安全性高技术难度大
显微血管吻合术适用于微小血管操作，精度较高需要高倍显微镜及特殊器械，技术难度大
磁性血管吻合术1）吻合快速，步骤简便；2）无异物残留，血管内膜更加平滑，血管损伤小技术应用在初期阶段，需进一步临床验证
激光血管吻合术1）高精度、快速，感染风险低；2）适用于需迅速精确完成血管连接的情景1）有渗漏问题，血栓形成风险增加；2）临床数据少，需进一步临床验证
血管耦合器/吻合器/夹子吻合术1）血管吻合流程简易，手术时间短；2）形成血栓风险降低1）可能导致血管变形等问题；2）运动或表浅等部位的使用有明显异物感
自动吻合机器人辅助技术手术精确度、操作灵活性及手术效率提高成本高，技术及设备普及度有限
黏合剂吻合技术1）手术时间缩短，操作负担减轻；2）术中出血风险降低，确保吻合处均匀性1）对大型或高压血管的连接效果有限；2）可能存在生物安全性问题
合成血管材料应用可生物降解材料有助于血管自然修复和生长材料生物相容性和长期稳定性仍需评估

《高阶颧种植：ZAGA理念》出版发行"

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