上斜方肌、肩胛冈骨肌皮瓣的解剖研究与临床应用  

Superior trapezius myocutaneous and osteomyocutaneous flaps: microsurgical anatomy and clinical applications

作　　者：王恩群[1] 张菊会 周健[3] 何家才[3] 王银龙[3] 王元银[3] 程继光[3] 

机构地区：[1]皖南医学院口腔系,芜湖241001 [2]合肥市中市区医院口腔科 [3]安徽医科大学口腔医学院

出　　处：《中华整形外科杂志》2001年第4期197-200,共4页Chinese Journal of Plastic Surgery

基　　金：.NULL.

摘　　要：目的　进一步探讨以颈横血管为蒂的上斜方肌肌皮瓣及肩胛冈骨肌皮瓣的应用解剖学基础 ,及其在口腔颌面缺损修复中的应用。方法　解剖观测 32侧上斜方肌、肩胛冈的形态和血供 ,并应用 5例该组织瓣修复口腔颌面部缺损。结果　①上斜方肌近似于梯形 ,平均高度上、下、内、外四缘分别为 174 6 3、15 7 18、86 98和 80 95mm ,面积 12 6 78cm2 ;肩胛冈全长 131 2 1mm。②颈横动脉干、颈浅动脉干及其升支、肩胛冈支长度分别为 42 5 0、2 7 80、43 12和 2 8 75mm。升支发出 0 5mm以上肌皮穿支 3～ 6支 ;回流静脉与相应动脉伴行。③临床应用 5例 ,均获成功。结论　以颈横血管为蒂的上斜方肌肌皮瓣及肩胛冈骨肌皮瓣血管蒂长、手术易操作 ,且可带肩胛冈修复 。Objective To explore the anatomic basis of the superior trapezius myocutaneous and osteomyocutaneous flap pedicled with the transverse cervical vessel, and provide a new operation for oral and maxillofacial reconstruction. Methods\ The blood vessels, the spina scapula and the superior trapezius muscle were dissected and examined in 32 cases. The flaps pedicled with the transverse cervical vessel have been applied to 5 cases of oral and maxillofacial defects. Results\ ①The shape of the superior trapezius muscle looks like a trapezium. The upper, lower, inner and outer borders of the muscle are 174 63mm, 157 18mm, 86 98mm, and 80.95 mm in average respectively. The area of the muscle is 126 78cm 2. The spina scapula is 131 21mm in length. ② The transverse cervical artery trunk, the superficial cervical artery trunk and its ascending artery, the spina scapulae branch artery are 42 50mm, 27 80mm, 43 12mm, 28 75mm in average respectively. The ascending artery gave 3～6 branches of over 0 5mm in diameter. The venous blood is mainly drained by the concomitant vein. ③All 5 flaps survived in oral and maxillofacial reconstruction. Conclusion\ The myocutaneous and osteomyocutaneous flap has long vascular pedicle, is easy for operation, and may also be transferred with the spina scapulae. The flap is an effective method in oral and maxillofacial reconstruction.

关 键 词：斜方肌 肩胛冈 颈横动脉 皮瓣 解剖学 临床应用 

分 类 号：R782.2[医药卫生—口腔医学]