尺动脉近端穿支皮瓣的应用解剖与临床应用  

Anatomy study and clinical application of proximal ulnar artery perforator flap

作　　者：魏义涛 钟桂午 梅劲[3] 唐茂林[3] 

机构地区：[1]南海创伤手足外科医院,广东省佛山市528231 [2]河北省涞源同济医院 [3]温州医学院人体解剖学教研室

出　　处：《中华显微外科杂志》2013年第5期447-450,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金项目（81071576）

摘　　要：目的探讨尺动脉近端穿支皮瓣的应用解剖及临床应用。方法自2008年起收集国人新鲜尸体10具（20侧），使用动脉显影技术进行灌注，所有标本进行层次解剖，观察尺动脉穿支血管穿出位置、穿支管径、蒂长及供血面积，重点观察尺动脉近端穿支相关指标；自2011年10月至2012年11月，针对手指及腕背皮肤软组织缺损病例，临床应用尺动脉近端穿支皮瓣游离移植修复手部缺损患者18例，应用该皮瓣面积3．0cm×2．5cm～10．0cm×5．5cm，18例供区均直接缝合，术后随访其疗效。穿支定位及皮瓣设计：自肱骨内上髁向豌豆骨作一直线，其近、中1／3交界点即为该穿支入皮点。以此点为中心设计带蒂或游离皮瓣。结果解剖显示近端穿支直径0．5～0．9mm，穿支蒂长33．0—47．0mm。从尺动脉发出营养前臂内侧的穿支数目为5—9支。所有病例均获得随访，随访时间6～14个月，皮瓣色泽正常、质地良好、厚薄适中，两点辨别觉5～8mm，无一例臃肿需要二期修整。供区外观、功能正常。结论尺动脉近端穿支易于定位，穿支出现恒定，管径较大，尺动脉近端穿支皮瓣适合于修复手及前臂等部位的中、小面积缺损。Objective To provide anatomical information and clinical application of flaps based on the proximal ulnar artery perforators. Methods Ten fresh cadavers who underwent injected with artery imaging technology and dissected with layer by layer;Eighteen patients who sought surgical treatment with proximal ulnar artery perforator flap for soft tissue defects of the finger and dorsum wrist at our hospital between October 2011 and November 2012 were included in this study. Results The diameter and superficial length of the main perforator respectively were 0. 5 - 0. 9 mm and 33.0 - 47.0 mm in our dissection. There were 5-9 perforators given from the ulnar artery to supply skin over the medial side of the forearm. All of the 18 flaps survived after surgeries. The flap size ranged from 3.0 cm ×2. 5 cm to 10. 0 cm ×5.5 cm. All of the transplanted flaps presented favourable contours and good functions at 6 to 12 months＇ followed-up. Conclusion Proximal ulnar arter perforator flap has favourable appearance, constant vascular pedicle, reliable blood supply, and large diameter. The free transplantation of this flap offers a satisfactory alternative for repairing the small and medium-sized area of soft tissue defects of forearm and hand.

关 键 词：尺动脉 穿支皮瓣 重建 应用解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]