滑车上动脉的解剖特点  

The anatomic features of supratrochlear artery

作　　者：蔡晓燕[1] 黎志明[2] 许扬滨[2] 程钢[2] 罗鹏[2] 

机构地区：[1]南方医科大学附属顺德第一人民医院烧伤整形外科,佛山528300 [2]广州中山大学附属第一医院整形修复外科

出　　处：《中华整形外科杂志》2009年第6期456-459,共4页Chinese Journal of Plastic Surgery

摘　　要：目的研究滑车上动脉未被发现或未被重视的解剖学特点，以减少额部旁正中皮瓣在修复鼻缺损时发生血运障碍的机率。方法于直视与手术放大镜下解剖10具20侧成人头部标本，观察滑车上动脉的行程、层次及吻合情况，以双侧眶上缘水平线为X轴，前正中线为Y轴的二维坐标系定位滑车上血管的出眶位置以及滑车上动脉穿出额肌的位置。结果滑车上动脉从眶上缘出眶后大致呈直线斜向内上行走，但部分（9／20）滑车上动脉起始处有一外凸的迂曲部。滑车上动脉层次表浅，在距离眶上缘水平线上方（15．2±2．6）mm、距离前正中线（12．1±1．4）mm处穿出额肌走行在皮下层，并沿原方向逐渐浅出紧贴真皮，在额上部与对侧滑车上动脉及同侧眶上动脉、颢浅动脉额支的分支相吻合。结论额部旁正中皮瓣蒂部不能过于狭窄，分离蒂部时不能太靠近滑车上动脉，以免损伤动脉的迂曲部影响皮瓣血运。额部旁正中皮瓣分离到眶上缘上2～3cm时则需在额肌深面分离，以免损伤滑车上动脉。Objective To explore the anatomical features of supratrochlear artery which is related to the blood supply of paramedian frontal flap in nasal reconstruction. Methods 10 adult head specimens（20 sides） were used for observation of the course, layer and anastomosis of the supratrochlear artery. The horizontal line of supraorbital rim and the frontal middle line were used as X and Y axis to locate the position of supratrochlear artery. Results Supratrochlear artery is directed medially and upward after it gets out from orbit. Some arteries （9/20） have one sharp bend at the beginning. The frontal muscle penestration point of the artery is（ 15.2 ± 2.6） mm above the X axis and（12.1 ± 1.4）mm lateral to the Y axis. The artery goes subcutaneously after muscle penestration point. It goes more superficially and is anastomoscd to the supraorbital artery and frontal branches of the superficial temporal artery at the same side, and also the contra-lateral supratrochlear artery. Conclusion The pedicel of the paramedian frontal flap should not be too narrow. The dissection of the pedicle should not be too near to the artery, so as to protect the bend at the beginning. The flap elevation must be performed beneath the frontal muscle, when it is 2 - 3cm above the supraorbital rim.

关 键 词：滑车上动脉 外科皮瓣 解剖学 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]