超声在带血管蒂肌皮瓣转移修复头颈部大面积组织缺损中的应用  

Application of High-frequency Ultrasound in Reconstruction of Large Defects in Head and Neck with Vascularized Myocutaneous Flaps

作　　者：潘云祥[1] 文艳玲[1] 潘朝斌[2] 罗葆明[1] 

机构地区：[1]中山大学附属第二医院超声科,广州市510120 [2]中山大学附属第二医院口腔科,广州市510120

出　　处：《中国超声医学杂志》2009年第1期27-29,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨高频超声在带血管蒂肌皮瓣转移修复头颈部大型组织缺损中的应用价值。方法肌皮瓣转移修复术前，对48例患者的60条轴心动脉进行高频超声检测，测量其内径、斑块大小、狭窄度及血流，对其走行进行体表定位并与术中所见进行对照。术后随访肌皮瓣存活情况。结果高频超声对60条轴心动脉均能显示。7例患者的10条（16．7％）轴心动脉存在明显的动脉硬化及不同程度的管腔变细或狭窄，其中血管内径最细仅约0．5mm，内径狭窄度最大达50％。所有轴心动脉体表定位与术中对照均一致。4例（8．33％）在高频超声检测后更改肌皮瓣，术后肌皮瓣均存活。术后随访2～30周，46例（95．8％）患者肌皮瓣存活，1例（2．08％）部份坏死，1例（2．08％）完全坏死。结论带血管蒂肌皮瓣转移修复头颈部大型组织缺损术前，借助高频超声可以准确评价肌皮瓣轴心动脉的血管条件及血流情况并进行体表定位，为临床上选择和设计肌皮瓣提供有价值的参考信息。Objective To investigate the usefulness of preoperative high frequency ultrasound （HFUS） in the instant reconstruction of large defects in head and neck region with vascularized myocutaneous flaps. Methods Sixty axial arteries in 48 cases were detected with HFUS preoperatively. The diameters of arteries, plaque size and stenosis rate were measured. The arterial origination, course and location were marked on patients＇ body surface and compared with the intr-operative findings. The survival of the flaps were follwed up. Results In 60 axial arteries, vascular sclerosis and stenosis were found in 10 axial arteries （16.7%） . The minimal arterial diameter was only 0.5 mm and the maximal stenosis rate was about 50%. The arterial origination, course and location marked preoperatively on patientg body surface were almost exactly matched with the intra-operative findings. Myocutaneous flaps in 4 cases （8. 33%） were changed preoperatively after ultrasound examination. During 2-30 months＇ follow-up, myocutaneous flaps in 46 cases （95.8%） survived well. Only one myocutaneous flap （2.08%） showed partial necrosis and one （2.08 %） showed whole necrosis. Conclusions It appears that HFUS can evaluate axial arteries accurately and can help make exact body marks, which is useful in selecting and designing axial pattern of myocutaneous flaps.

关 键 词：高频超声 带血管蒂肌皮瓣 轴心动脉 

分 类 号：R737.906[医药卫生—肿瘤] R622.1[医药卫生—临床医学]