小腿部穿支血管测量及其在螺旋桨皮瓣设计中的应用  

Measurement of perforator vessels in the crus and its application in propeller flap designing

作　　者：买丽娇 黄文华[2] 黎娇莹 梁梦萍 张世民[3] 沈立锋[2] 

机构地区：[1]南方医科大学基础医学院,广州510515 [2]南方医科大学人体解剖学教研室,广州510515 [3]同济大学附属杨浦医院骨科,上海200090

出　　处：《解剖学杂志》2014年第4期511-513,542,共4页Chinese Journal of Anatomy

基　　金：国家“863”计划项目（2012AA02A603）;国家自然科学基金（81271993）

摘　　要：目的：以胫后动脉和腓动脉为重点,对小腿部穿支血管进行解剖学研究,为皮瓣穿支血管蒂的选择及皮瓣设计和旋转提供解剖学依据,从而减少术后静脉回流障碍.方法：选取21侧小腿标本进行灌注,对小腿部胫后动脉、腓动脉的穿支血管进行细致解剖,测量穿支位置、直径、动静脉比例等数据.结果：胫侧穿支血管蒂的平均长度为（1.948±0.588） cm,腓侧为（3.286±0.768） cm;胫侧发出点距内踝的平均距离为（10.723±1.791） cm,腓侧发出点距外踝的平均距离为（12.260±2.762） cm;胫侧有2支伴行静脉的穿支占53.1％,有1支伴行静脉的占40.8％,腓侧分别为64.6％和33.3％,几乎所有穿支动脉均有上、下行支.结论：小腿部有较为恒定的穿支血管发出,穿支血管几乎均有上、下行支,以此设计螺旋桨皮瓣较为可靠.穿支蒂动静脉比例、口径、位置关系以及走行角度可作为皮瓣设计、切取、旋转的参考指标.Objective：To provide the anatomy evidence of the choosing of perforator vessels,designing and rotating of pedicled perforator flap,sequentially reducing the venous congestion.Methods：After choosing and perfusing the specimen,we dissected the perforator vessel of posterior tibial artery and fibular artery in the lower leg to get the statistics of location,diameter and proportion of artery and vein of perforator vessels.Results：The average length of tibial vascular pedicle was about （1.948±0.588） cm,while fibular vascular pedicle was about （3.286±0.768） cm.The distance between the starting point of tibial perforator vessels and malleolus medialis was （10.723 ±1.791） cm,while the distance between the starting point of fibular perforator vessel and lateral malleolus was （12.260 ± 2.762） cm.The tibial vascular artery pedicle had two perforators accompanying vein amounts to 53.1％,with an accompanying vein of 40.8％,while the fibular vascular artery pedicle of 64.6 ％ and 33.3 ％.Almost all the perforators had ascending branch and descending branch.Conclusion：There are constantly perforator vessels in the lower leg and they almost all have ascending branch and descending branch.It is credible that we design the propeller flap with these perforator vessels.The ratio of artery and vein,diameter,location relation and angle of perforator vessels can be used as a reference index of designing,harvesting,and rotating the flap.

关 键 词：小腿 穿支血管 螺旋桨皮瓣 

分 类 号：R782.2[医药卫生—口腔医学]