皮神经伴行血管皮瓣内浅静脉干不同处理方法的临床研究  

Different approaches of the superficial veins in the neurocutaneous flap: a clinical study

作　　者：李展新 夏霆 徐基农 

机构地区：[1]恒生手外科医院,广州510095

出　　处：《中华手外科杂志》2005年第6期346-347,共2页Chinese Journal of Hand Surgery

摘　　要：目的探讨皮神经伴行血管皮瓣内浅静脉干不同处理方法对皮瓣的影响。方法对137例手、足软组织缺损的患者,分别采用带桡神经浅支、尺神经手背支及腓肠神经伴行血管为主的筋膜蒂逆行岛状皮瓣,术中对皮瓣内浅静脉采取静脉干不结扎、结扎组和吻合等三种不同的处理方法。结果术后浅静脉干不结扎组(27例),皮瓣出现不同程度的水泡、肿胀、青紫色,术后第7天皮瓣远端部分坏死。结扎组(87例)和吻合组(23例),术后皮瓣无静脉危象出现,两组皮瓣全部成活。结论对皮神经伴行血管皮瓣内浅静脉干吻合是三种术式中最理想的方法,而对浅静脉干结扎是三种中最实用、有效的方法。Objective To investigate the influence of various methods of handling the superficial vein on the survival of flaps supplied by the vascular axis of superficial sensory nerves. Methods 137 cases of hand and foot soft tissue defects were treated with distally based neuro-fasciocutaneous flaps pedicled on the superficial radial nerve, dorsal cutaneous branch of the ulnar nerve, and the sural nerve. The superficial veins in the flaps were either left alone （27 cases）, ligated （87 cases）, or anastomosed （23 cases）. Survival of the flaps were observed postoperatively, Results Various degrees of swelling, blister, and ecchymosis were seen in flaps where the superficial veins were left alone. Partial necrosis occurred at the distal end of the flaps 7 days postoperatively. No venous drainage insufficiency was observed in flaps where the superficial veins were either ligated or anastomosed. All flaps in these two groups completely survived. Conclusion Anastomosis of the superficial vein in the neurocutaneous flap is the optimal method to secure sufficient venous drainage. Ligation of the vein is an alternative which is most practical.

关 键 词：外科皮瓣 静脉 岛状皮瓣 静脉回流 治疗结果 

分 类 号：R658[医药卫生—外科学]