游离股后侧穿支动脉皮瓣的解剖学研究及临床应用  

Anatomic study and clinical application of perforator free flap in posterior region of thigh

作　　者：王剑利 王根 赵刚 郭永强 王五洲 

机构地区：[1]山东省潍坊市,解放军第八十九医院全军创伤骨科研究所,261021

出　　处：《中华显微外科杂志》2013年第1期7-10,共4页Chinese Journal of Microsurgery

摘　　要：目的通过研究股后侧区的穿支动脉解剖特点和分布规律，设计切取以该区域穿支血管为蒂的游离皮瓣。方法利用新鲜尸体8具乳胶加铅灌注标本对股后侧区域内血管解剖结构尤其是穿支血管走行及分布进行研究，筛选口径、长度及走行适合做吻合血管蒂的穿支。临床上实际应用7例，均为穿支游离皮瓣，皮瓣大小：3am×8cm-8cm×16cm，第一穿动脉皮瓣3例，第二穿动脉皮瓣2例，第三穿动脉皮瓣1例，第一穿动脉上无名穿支皮瓣1例。结果解剖研究发现，该区域适合做游离皮瓣的穿支有4～5条，平均外径0．4～2．8mn；平均长度2．2～9．0cm。7例穿支皮瓣均成活，随访5～11个月，穿支皮瓣修复创面后皮肤弹性好，皮瓣薄，外形美观。结论股后侧区的穿动脉分布较多、口径长度适宜，以该区域设计切取穿支血管游离皮瓣部位隐蔽、可直接缝合供区，临床应用效果满意。Objective To study how design and harvest perforating artery free flaps in posterior region of thigh based on research of the anatomical features and distribution regularities of those perforating artery. Methods Using 8 fresh bodies specimen with latex leaded perfusion of inferior gluteal area to study perforator artery anatomy structure and distribution of rear thigh. Screen the fitting perforator arteries for perforator free flap both in caliber and length. Total 7 cases were performed with perforator free flap in posterior thigh, the flap size： from 3 cm × 8 cm - 8 cm × 16 em, and the first perforating artery flap carried out in4 cases, the second perforating artery flap in 2 cases, the third perforating artery flap in 1 case. Results Anatomic study showed that perforating artery suitable for free flap in this area were in teams of 4 to 5, the average diameter were in range of 0.4 to 2. 8 ram, the average length was 2. 2 - 9. 0 cm. Seven cases had been applied with perforator flap and all survived. Foflowed-up from 5 to 11 months, the wounds repaired by the perforator flap of posterior thigh presented fine elasticity, thin flap, beautiful appearance. Conclusion The distribution, length and diameter of perforating artery in posterior region of thigh are suitable for perforator free flap. Being hidden, direct close the posterior region of thigh expected to acchive satisfactory clinical effects.

关 键 词：股深动脉 穿支动脉 穿支皮瓣 显微外科手术 

分 类 号：R6[医药卫生—外科学] R3[医药卫生—临床医学]