膝上长血管联合游离组织瓣修复小腿严重创伤的应用解剖  

Applied anatomy of free flap transplant with long superior genicular vessles in reconstruction of lower leg＆#39;s smashed wound

作　　者：林加福[1] 林涧[2] 吴碧莲[1] 陈玲珑[1] 

机构地区：[1]福建卫生职业技术学院基础部,福州350101 [2]上海交通大学医学院附属新华医院显微外科

出　　处：《中华显微外科杂志》2014年第6期578-581,共4页Chinese Journal of Microsurgery

基　　金：福建省教育厅科研项目（2013JBl3333）

摘　　要：目的 解剖观测膝上长血管（旋股外侧动脉降支血管、膝降动脉）,探讨其联合游离组织瓣移植修复小腿严重创伤的可行性. 方法 30侧成人下肢标本,以髂前上嵴、髌骨上缘和收肌结节为观测标志,沿腹股沟韧带中点与髌骨上缘中点切开皮肤,分别向后外侧、后内侧翻开,解剖观测：①旋股外侧动脉降支血管的起始外径,0.5 mm外径时与起始处、髌骨下缘的距离.②膝降动脉起始处的外径,起始处距收肌结节距离.③旋股动脉降支、膝降动脉终末血管与髌周血管间的吻合关系. 结果 旋股外侧动脉降支血管起始处的外径为（2.73±0.35） mm,外径为0.5 mm外径时与起始处、髌骨下缘的距离分别为（24.56±0.92） cm、（6.09±0.86） cm;膝降动脉的起始外径为（2.19±0.31） mm,起始处距收肌结节的距离为（8.45±0.97） cm.旋股外侧动脉降支和膝降动脉在下行过程中均发出多支分支,终支参与膝关节动脉网的形成,与膝周其他动脉在骨膜处、深筋膜层和浅筋膜层均有广泛的吻合. 结论 理论上旋股外侧动脉降支血管和膝降动脉有足够的长度和血供,可逆行转位吻合游离组织瓣修复小腿严重创伤.Objective Anatomical researches of two long superiror genicular vessels,the descending branch of lateral circumflex femoral artery （LCFA） and the descending genicular artery（DGA）,were performed to discuss the feasibility of reconstruction in lower leg＆#39;s destruction injury by free flaps transplant anastomoses with these two long superior genicular vessels.Methods Thirty embalmed lower limb specimens from adult cadavers perfused with red latex were used for this anatomical study.The superior of patella,anterior inferior iliac spine and adductor tubercle were used as observation landmark.Dissection started along the line that from the middle point of Inguinal Ligament to the middle point of superior line of patella,and dividedly turned over to posterior lateral part and posterior medial part.The followings were focused observed：①The external diameter at the beginning of the D-LCFA ; the 0.5 mm external diameter point of this artery,and its length to the beginning and superior of patella.②The external diameter at the beginning of DGA,the distance between the beginning of DGA and adductor tubercle.③Anastomoses relations of final branches of D-LCFA and DGA with other arteries around the knee.Results The external diameter of the beginning of D-LCFA was （2.73 ± 0.35） mm ; the 0.5 mm external diameter point of this artery＆#39;s length to the beginning and to the superior of patella were （24.56 ± 0.92） cm and （6.09 ± 0.86） cm; both D-LCFA and DGA had sent out many perforator arteries on their ways; the final branch of D-LCFA and DGA had lots of anastomoses relations in perioseal deep fascia and superficial fascia with other genicular arteries.Conclusion Base on the anatomical researches,in theory,the two long superior genicular vessels （D-LCFA and DGA） have enough lengthes and blood supply to regress and anastomosis with free flaps transplant to repair lower leg＆#39;s smashed wound.

关 键 词：旋股外侧动脉 膝降动脉 游离组织瓣 应用解剖 

分 类 号：R658.3[医药卫生—外科学]