以睑缘动脉弓为蒂的睑缘复合组织瓣的解剖学及临床应用  

Anatomical features and clinical application of compound flap pedicled with arterial arch of palpebral margin

作　　者：赵天兰[1] 程新德[1] 熊绍虎[2] 谢晓明[1] 余道江[1] 

机构地区：[1]苏州大学附属第二医院整形美容外科,苏州215004 [2]上海第二军医大学解剖学教研室

出　　处：《中华医学美学美容杂志》2008年第3期148-151,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的通过对眼睑血供解剖的详细观测，为应用以睑缘动脉弓为蒂的睑缘复合组织瓣修复眼睑缺损提供解剖学依据，并证明该方法是一种修复睑缘全层缺损的理想方法。方法对15具尸体30侧眼睑进行解剖学观测，重点研究睑缘动脉弓的血供来源、走行分布、外径及吻合情况。对30例临床病例进行回顾性总结，评价本术式的治疗效果。结果眼睑由内向外可分为皮肤、皮下组织、肌肉层、睑板层、结膜层5层。眼睑内的大部分血管互相吻合，血液循环丰富。鼻背动脉的分支和泪腺动脉的分支共同组成睑缘动脉弓和周边动脉弓，共同营养睑板前后的组织。临床30例睑缘复合组织瓣全部成活，伤口Ⅰ期愈合，无明显继发畸形，外形满意。结论以睑缘动脉弓为蒂的睑缘复合组织瓣血供可靠，用于睑缘全层缺损的修复为同类组织修复，是一种理想并且效果满意的修复睑缘缺损的方式。Objective To explore the anatomical basis for clinical application of the compound flap pedicled with arterial arch of palpebral margin by observing eyelid blood supply and anatomical structure and to prove that it is an ideal method of repairing the eyelid defect for clinical application. Methods 15 adult cadavers （30 eyelids） were dissected. The origin, course, branches, diameters and vessel networks of palpebral margin arterial arch were observed particularly. 30 cases of eyelid marginal defect were reviewed and the therapeutic effect of this method evaluated. Results Eyelid was constituted by 5 layers： skin, subcutaneous tissue, muscle, tarsal plate and conjunctival layers. Most eyelid vessels were mutually anastomosed to form a constant vessel network. Palpebral margin arterial arch and peripheral arterial arch were formed by dorsal nasal artery branches and lacrimal artery branches, both of which nourished the eyelid tissue. All the compound flaps of 30 cases survived completely without any complications. All cases obtained satisfactory resuits functionally and esthetically. Conclusions The arterial arch of palpebral margin is constant and the blood supply of the compound flap is reliable. It can repair full eyelid defect with the same kind of tissue, and obtain satisfactory appearance. It is an ideal method of repairing the eyelid defect.

关 键 词：眼睑 解剖学 睑缘动脉弓 复合组织瓣 临床应用 

分 类 号：R779.6[医药卫生—眼科]