腓浅动脉穿支皮瓣的应用解剖学研究  

Applied anatomy of the superficial peroneal artery perforator flap

作　　者：杨晓东[1] 王建红[2] 吴东方[2] 梅劲[2] 刘杨武[1] 杨锦[1] 张根福[1] 唐茂林[2] 

机构地区：[1]温州医学院附属义乌医院手足外科,浙江义乌322000 [2]温州医学院解剖学教研室,温州325035

出　　处：《中国临床解剖学杂志》2011年第6期629-632,共4页Chinese Journal of Clinical Anatomy

基　　金：浙江省科技厅资助项目(2010C33012)

摘　　要：目的为腓浅动脉穿支皮瓣的临床应用提供解剖学依据。方法新鲜成人尸体20具(40侧),行一次性全身乳胶灌注5具,全身动脉造影15具。通过直接层次解剖,应用图像分析和测量系统Scion image,对小腿前外侧区穿支进行定性、定量分析;螺旋CT扫描数据以DICOM格式输入Mimics图像工作站,对腓浅动脉穿支皮瓣进行三维重建。结果该区共有外径≥0.5mm的穿支(7.0±3.0)支,外径(0.7±0.2)mm,蒂长(3.3±1.7)cm,穿支的供血面积(33.0±8.0)cm2。腓浅动脉起始外径(1.2±0.3)mm,干长(5.6±1.8)cm,与中、下1/3处腓浅下外侧动脉及腓动脉终末穿支吻合构成一条几乎不减少口径的血管链。结论腓浅动脉与腓浅下外侧动脉及腓动脉终末穿支相吻合构成的血管链供养小腿前外侧区皮肤,由此设计腓浅动脉穿支皮瓣是切实可行的。Objective To provide morphological data that enables safe elevation of the superficial peroneal artery perforator flap.Methods Five fresh unfixed corpses underwent whole body red latex injection.Fifteen fresh cadavers injected with a modified lead oxide-gelatin mixture for three-dimensional reconstruction using a spiral computed tomography scanner and specialized software（MIMICS）.All of specimens were then dissected by layers.Angiography and photography were used to document the precise course,size,location,and type of individual perforators in the anterolateral leg region.The surface areas of cutaneous territories and perforator zones were measured and calculated with Photoshop and Scion Image.Results The skin and muscles on the anterolateral leg are nourished by anterior tibial artery perforators and the descending branch of peroneal artery perforator.There were（7±3.0） perforators with diameters of greater than or equal to 0.5 mm.The average external diameter was（0.7±0.2） mm.Each perforator supplied an average area of（33.0±8.0） cm2.The diameter of the superficial peroneal artery was（1.2±0.3） mm at its origin from the anterior tibial artery below 5cm the head of the fibula,and the length was（5.6±1.8） cm.This artery was truly anastomoses with others perforaors to form the chain of superficial peroneal nerve accessory artery.Conclusions The anterolateral leg is an excellent donor site for local and distant flaps.Perforator flaps could be based on the chain of superficial peroneal nerve accessory artery.The volume rendering technique is very useful for preoperative flap design.

关 键 词：腓浅动脉 穿支皮瓣 应用解剖 数字解剖 显微外科 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]