旋前方肌肌皮双叶瓣的解剖学基础  

The anatomical basis of bilobed myocutaneous flap of the pronator quadratus muscle

作　　者：杨新东[1] 崔怀瑞[1] 徐象党[1] 周鹏[1] 

机构地区：[1]温州医学院解剖学教研室,浙江温州325035

出　　处：《温州医学院学报》2007年第6期546-548,共3页Journal of Wenzhou Medical College

摘　　要：目的:阐明旋前方肌的肌内血管分布状况及肌皮双叶瓣的解剖学基础。方法:26侧前臂标本分别进行改良明胶/氧化铅灌注(14侧)或明胶墨汁灌注(12侧),层次解剖观测旋前方肌及骨间前动脉,测量其管径及其走行、分支、分布情况并拍摄X线片。应用电脑图像处理软件(ScionImage for Windows)分析旋前方肌肌皮瓣供区面积等。结果:旋前方肌体积5.5cm×5.0cm×1.0cm,按血供方式可定义为Ⅱ型肌(Mathesand Nahai分类)。其血供以骨间前动脉血管为主,桡、尺血管为辅。骨间前血管蒂长9.6cm,动脉直径2.3mm,静脉直径2.8mm。骨间前动脉的背侧皮穿支(DPB)营养前臂背侧和腕背的皮肤,该支与1,2支持带上动脉中间支相吻合,DPB平均直径是1.2mm,伴行静脉平均直径是1.3mm,分布平均面积是21cm2。结论:本研究证实了旋前方肌瓣及其肌皮双叶瓣的血管基础及它们的潜在应用价值。Objective：To illuminate the intramuscular vascular supply of the pronator quadratus muscle and its anatomical basis of bilobed myocutaneous flap. Methods： The pronator quadratus muscle（PQ） and its neurovascular pedicle from fresh human cadavers were dissected and X-Ray after an intra-arterial injection of lead oxide-gelatin solution （n=14） or Chinese ink-gelatin mixture （n=12）. The vessels were identified,noting vascular origin and pedicle length. Radiographs of tissue specimens were digitally analyzed using the software Scion Image for Windows to determine vascular territories. Results： Pronator quadratus muscle could be classified as a type Ⅱ （Mathes and Nahai classification） muscle, with a major pedicle （the anterior interosseous vessels） and two minor pedicles （the radial and ulnar vessels）. The mean values were： dimensions of the muscle 5.5 cm × 5.0 cm × 1.0 cm, pedicle length 9.6 cm,diameter of the artery 2.3 mm and vein 2.8 mm. The dorsal cutaneous perforating branch of the anterior interosseous artery （DPB） supplied the skin over the dorsal forearm and wrist.This branch also anastomosed with the 1,2 intercompartmental supraretinacular artery. The average diameter of the DPB was 1.2 mm and the vien 1.3 mm. The mean area of skin supplied by the DPB was 21 cm^2. Conclusion： The vascular basis of the pronator quadratus muscular flap and the bilobed myocutaneous flap is validated in this paper. The potential applied value is also validated in this paper.

关 键 词：骨间前动脉 旋前方肌 肌皮瓣 血管造影 应用解剖 

分 类 号：R614[医药卫生—麻醉学] R654.1[医药卫生—外科学]