数字技术在研究薄型股前外侧皮瓣中的应用  

The application of digital technology on study of the thin anterolateral thigh flap

作　　者：江奕恒[1] 徐达传[2] 

机构地区：[1]广东省第二人民医院创伤外科,广州510317 [2]南方医科大学临床解剖学研究所,广州510515

出　　处：《中国临床解剖学杂志》2009年第1期1-4,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金项目资助(A2005174)

摘　　要：目的:探索数字技术模拟皮瓣供血结构的变化对皮瓣皮肤血供的影响,为薄型股前外侧皮瓣中的应用提供数字解剖学依据。方法:6侧动脉灌注氧化铅-明胶的新鲜成人下肢标本,显微解剖观察股前外侧区皮肤穿支血管的走行、结构,在去脂肪修薄皮肤的过程中,分步拍摄X线片并行螺旋CT连续扫描,观察、分析皮肤血管结构。分别对保留和破坏筋膜支的标本行螺旋CT连续扫描,同时应用计算机软件分别对源于旋股外侧动脉的各条皮穿支进行血管三维重建。结果:三维重建的数字化模型可准确反映皮瓣筋膜丛及真皮下血管丛的基本情况,可准确直观模拟皮瓣修薄前后各皮穿支的基本供血结构;三维重建的数字化模型与显微解剖、X线片观察结果一致。结论:数字化模拟技术能够客观模拟各皮穿支在皮瓣修薄前后供血区域的变化;缺乏筋膜丛的区域,真皮下血管丛较发达,皮瓣修薄后,其皮肤血供不受影响。Objective： To investigate the effect of the changes of the simulated blood supply of skin flap on the blood supply of skin flap and provide the digital anatomical basis for the application of the thin anterolateral thigh flap. Methods： 6 sides of fresh adult lower limbs specimens were microdissected after perfusing with oxide-gelatine in artery. Courses and features of the perforating vessels in the anterolateral thigh flap were studied under the operating microscope. During the process of removing fat, X-ray film were taken in each step and multi-slice CT scane was done in series, and subsequently vessel＇s constitution in skin was analyzed. Intact and destroyed fascia branches of specimen were scaned in series by multi-slice CT respectively, meanwhile each cutaneous branch of arteria circumflexa femoris lateralis was three-dimensional reconstructed by use of a special computer software. Results： Digital model of three-dimensional reconstruction revealed basic information of the fascia and subdermal vascular plexus of skin flap, and simulated the blood supply of each cutaneous branch in the flap. The results from digital model of three-dimensional were resemble as that of microdissection and x-ray. Conclusions： Digital simulation technique can simulate objectively the changes of blood supply of every cutaneous branch in the skin flap. In the area absencing fascia, subdermal vascular plexus develops fairly, which can compensate blood supply of the thin anterolateral thigh flap.

关 键 词：股前外侧 薄型皮瓣 皮肤血管 三维重建 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R616.2[医药卫生—基础医学]