远端蒂尺侧上副动脉穿支皮瓣的应用解剖  

The anatomical study of superior ulnar collateral artery perforator flap

作　　者：李瑞君[1] 路来金[1] 宫旭[1] 张志新[1] 宣昭鹏[1] 崔建礼[1] 

机构地区：[1]吉林大学第一医院手外科,长春130021

出　　处：《中国临床解剖学杂志》2011年第1期21-24,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的为远端蒂尺侧上副动脉穿支皮瓣设计提供解剖学基础。方法通过对14侧红色乳胶灌注的新鲜成人上肢标本进行显微解剖,观测尺侧上副动脉穿支的起源、走行、数量、外径及吻合情况。结果尺侧上副动脉起点距肱骨内上髁上方(16.6±1.9)cm,外径(1.6±0.2)mm,穿支动脉出现率93%,在尺侧上副动脉全程都有分布,管径0.5～1.3 mm之间,并在深筋膜表面形成纵向稠密的血管吻合网。远端穿支位置相对恒定,距肱骨内上髁上方距离(3.3±1.2)cm,管径(0.9±0.3)mm,并与尺侧下副动脉、尺侧返动脉发出的皮肤穿支形成血管吻合,有1～2条伴行静脉,直径(0.8±0.4)mm。结论尺侧上副动脉穿支所形成的血管吻合网血供可靠,远端穿支管径较粗、位置恒定,以肱骨内上髁上方3 cm尺侧上副动脉远端穿支穿出点为皮瓣旋转点,以臂内侧中下部皮肤为供区,不携带尺侧上副动脉,设计远端蒂尺侧上副动脉穿支皮瓣,可用于修复肘关节皮肤缺损。Objective To introduce the anatomical study of the medial ann flap based on superior ulnar collateral artery perforator, in order to simplify the conventional operating method. Methods Microsurgical anatomical study was carried out on 14 fresh upper limbs of human cadavers. The study was focused on the origin, numbers, diameter, courses and vascular anastomosis of perforator arteries originated from superior ulnar collateral artery. The nonconventional flap was designed according to the distal perforating vessels and the rotational point, vessel axis, donor area and incision level are involved. Results The superior ulnar collateral artery originates from the brachial artery or deep brachial artery at （16.6±1.9）cm proximal to internal condyle of humerus. The diameter of it is （1.6±0.2）mm at the original site. In 93 % cadavers, about 2-4 fasciocutaneous perforators could be found and distal perforators are relatively constant. The original diameter of the distal perforator artery is （0.9±0.3）mm and its original point is （3.3±1.2）cm above the internal condyle of humerus. The fasciocutaneous perforators which originated from inferior ulnar collateral artery join in the chain-linked longitudinal or network vascular plexus, which come from superior ulnar collateral artery .The perforating veins at the pedicle of flap is the most important factor in system of venous drainage. Conclusions The study provides the anatomic data on the origin, numbers, diameter, courses and vascular anastomosis of perforator arteries originated from the superior ulnar collateral artery, and provide the anatomic evidence for the superior ulnar collateral artery perforator flap.

关 键 词：臂 尺侧上副动脉 穿支 外科皮瓣 应用解剖 

分 类 号：R622.3[医药卫生—整形外科] R622.1[医药卫生—外科学]