胸背动脉肌皮穿支皮瓣的解剖学研究与临床意义  

The thoracodorsal artery musculocutaneous perforator flap： anatomic study and clinical significance

作　　者：侯团结[1] 高学宏[2] 郑和平[3] 宁金龙[2] 李小静[2] 李平松[1] 陈啸[1] 

机构地区：[1]扬州大学临床医学院江苏省苏北人民医院整形美容中心,225001 [2]安徽医科大学第一附属医院整形外科 [3]南京军区福州总医院军区临床解剖学研究中心

出　　处：《中华整形外科杂志》2007年第3期202-205,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨背阔肌肌皮穿支皮瓣的解剖学基础及临床应用的可行性。方法①在15具（30侧）防腐成人尸体标本上，对背阔肌及其主要血供进行巨微解剖学观察。②对1具（2侧）防腐成人尸体标本作背阔肌肌皮穿支皮瓣及肌瓣与穿支肌皮瓣分离的共蒂“扇形”瓣模拟手术。结果①在32侧标本中，共发现血管外径大于0．5mm的肌皮穿支102支，其中来自胸背动脉内侧支的穿支数为56支（占55％），来自胸背动脉外侧支的穿支数为46支（占45％）。每侧标本内侧支平均发出1．9支（在1-3支之间变化），外侧支平均发出1．8支（在1-3支之间变化）。②胸背动脉内、外侧支的肌皮穿支外径大于0．5mm的穿支血管主要集中在距神经血管窗下约8．5cm（变化在6．4-9．2cm之间）范围内。结论胸背动脉的肌皮穿支血管位置恒定，管径粗，蒂长，适宜制作成肌皮穿支肌皮瓣或“扇形”瓣。Objective To investigate the feasibility of clinical application of the thoracodorsal artery musculocutaneous perforator flap （TAMPF）. Methods①The morphosis and blood supply of TAP flap on 15 formalized adult cadavers（30 sides） were examined by microsurgery anatomy. ②An imitative operation of the TAMP flap and latissimus dorsi flap on 1 formalized adult cadavers（2 sides） was conducted. Results ①A total of 102 musculocutaneous perforators larger than 0.5 mm were found in 16 specimens（32 sides）. 56 perforators （55%） were originated from the medial branch and 46（45% ） originated from the lateral branch. The biggest perforator is （0.82±0.11 ） mm（0.68±1.08 mm）. There was an average of 1.9 perforators（ range, 1 - 3 perforators） of the medial branch and an average of 1.8 perforators（ range, 1 - 3 perforators） of the lateral branch. Additionally, there were 24 perforators samller than 0.5 mm, and 76 perforators originated from intercostal artery and lumbar artery.②Musculocutaneous perforators over 0.5 mm were found only in proximity of the medial and lateral branches within a distance of 8.5 cm（6.4 cm - 9.2 cm） distal to the neurovascular hilus. Conclusions With the characteristics of constant position, large caliber, long pedicle, the thoracodorsal artery musculocutaneous perforator was suitable to be musclocutaneous perforator flaps and ＂fan-shaped＂ flaps.

关 键 词：胸背动脉 穿支皮瓣 解剖 

分 类 号：R686[医药卫生—骨科学]