胸肩峰动脉穿支皮瓣的应用解剖研究  

Applied anatomy study of thoracoacromial artery perforator flap

作　　者：王旭[1] 谢松林[2] 邬娇[3] 刘志中[4] 孙辉平[3] 周晓[1] 李赞[1] 宋达疆[1] 

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,湖南长沙410013 [2]南华大学附属南华医院手足外科,湖南衡阳421001 [3]湖南省肿瘤医院麻醉科,湖南长沙410013 [4]湖南省肿瘤医院泌尿外科,湖南长沙410013

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第2期137-140,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：湖南省自然科学基金面上项目(13JJ5012);湖南省科技计划项目(2014SK3002);湖南省卫计委课题项目(B2014-111)

摘　　要：目的为胸肩峰动脉穿支皮瓣的临床应用提供解剖学基础。方法取新鲜成人尸体8具,其中男7具,女1具;死亡年龄30~73岁,平均年龄48岁。尸体标本经股动脉灌注加入氧化铅的红色凝胶后,在上至锁骨,下至第五肋,外至腋前线,内至胸骨旁的区域内通过解剖和影像学方法观察胸肩峰穿支动脉的出现率、位置、走行与周围血管的吻合,并测量胸肩峰动脉穿支管径及蒂长。结果 8具标本16侧均出现胸肩峰动脉皮穿支,从胸大肌锁骨头和胸肋头间的肌间隙穿出,管径平均0.84 mm;蒂长平均7.12 cm;与胸外侧动脉,胸廓内动脉来源血管吻合丰富。结论胸肩峰动脉穿支皮瓣穿支出现率高,位置恒定,血管蒂长与周围血管吻合丰富,皮瓣切取范围大,设计灵活,不损伤胸大肌,可用于头颈颌面部的组织缺损修复。Objective To provide the anatomical basis for clinical application of thoracoacromial artery perforator flap. Methods 8 fresh adult cadavers （ 16 hemichests） including 7 males and one female were dissected. Their age at death ranged from 30 to 73 years old with an average of 48. Red-marker gel containing lead oxide was perfused via femoral artery. Over the territory with boundaries of the clavicle superiorly, the anterior axillary line laterally, the fifth rib inferiorly, and the parasternal line medially, thoracoacromial artery perforator was recorded by both anatomical and imaging methods of the occurrence rate, location, direction, and peripheral vascular anastomosis. The caliber of the perforator and the length of the vascular pedicle were also measured. Results Thoracoacromial artery perforator was present in all 16 hemichests. All the perforator semerged the pectoralis major muscle from the septum between the clavicular and sternocostal heads of the muscle. The mean caliber of the perforator was 0.84 mm and the mean length of the vascular pedicle was 7.12 cm. The perforator had rich vascular anastomosis with the lateral thoracic artery and internal mammary artery. Conclusions Thoracoacromial artery perforator exists consistently with constant location, long vascular pedicle and rich peripheral vascular anastomosis. With advantages of large perforating area, flexibility indesign and maintenance of pectoralis major muscle integrity, thoracoacromial artery perforator flap is suitable for defect reconstruction in the head and neck.

关 键 词：胸肩峰动脉 穿支皮瓣 修复 

分 类 号：R323.2[医药卫生—人体解剖和组织胚胎学]