腹壁下动脉后鞘穿支腹膜瓣的应用解剖学研究  

Applied anatomy of deep inferior epigastric artery posterior rectus sheath peritoneum flap

作　　者：李武[1] 于小平[1] 崔怀瑞[2] 潘爱华[3] 曾勇[1] 易孝纯[1] 易亮[1] 唐茂林[2] 周晓[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院/湖南省肿瘤医院,长沙410013 [2]温州医科大学解剖学教研室,浙江温州325035 [3]中南大学湘雅医学院解剖学教研室,长沙410013

出　　处：《中国临床解剖学杂志》2016年第1期16-20,共5页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(31371214);中南大学中央高校基本科研业务费专项资金(2015zzts325);湖南省肿瘤整形外科临床医疗技术研究中心(2013TP4087)

摘　　要：目的应用Mimics及CT配套工作站,三维构建以后鞘腹膜瓣为特色的腹壁下动脉血管体,为以腹壁下动脉为蒂的多类型组织瓣的临床应用提供形态学资料。方法 5具新鲜成人尸体标本行全身一次性明胶/乳胶-氧化铅动脉灌注:1 64排螺旋CT扫描,数据在Mimics工作站及CT配套的工作站分别进行三维建模与分析。2截取腹前壁标本行层次解剖及X线摄片。结果腹壁下动脉走行过程中分出后鞘腹膜支、肌支、外侧支以及肌皮穿支。有3支外径≥0.5 mm的后鞘腹膜支,分别与肌支、肌皮穿支共干。结论以腹壁下动脉为蒂可制备后鞘腹膜瓣、肌瓣、皮瓣,及复合组织瓣,修复人体多处多种类型的复杂缺损,尤其适用于口腔颌面部洞穿性缺损的修复。Objective To 3D reconstruct the angiosomes of the deep inferior epigastric artery （DIEA） using Mimics and CT supporting workstations, in order to provide morphological evidence for clinical application of different types of tissue flaps with the DIEA as the vascular pedicle. Methods The systemic arteriography using the mixture of lead oxide-gelatin or oxide-latex was performed on five fresh adult cadavers. （1） Data serially scanned by 64 slice spiral CT were 3D modeled and analyzed in Mimics and CT supporting workstations respectively. （2） The anterior abdominal walls of the five cadavers were sectioned, observed by layers dissection combined with X-ray examination. Results The DIEA distributed into musculoperitoneal branches, muscular branches, lateral branches and musculocutaneous perforators. 3 musculoperitoneal branches with the diameter≥0.5 mm, which had the same vascular pedicle with muscular branches and musculocutaneous perforators, respectively. Conclusions Different types of tissue flaps with the DIEA as the vascular pedicle, such as the musculoperitoneal flap, muscle flap, cutaneous flap and composite flap, can be harvested to reconstruct complicated defects of different parts and of various types, especially for the through and through defects reconstruction in oromaxillo-facial region.

关 键 词：腹壁下动脉 血管造影 三维重建 后鞘腹膜瓣 穿支皮瓣 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R323.2[医药卫生—基础医学]