腓动脉穿支皮瓣及其穿支血管超声定位的临床应用  

Clinical application of ultrasound positioning of peroneal artery perforator flap and its perforating vessel

作　　者：施晓成 于鹏丽[3] 王淑琴[1] 蒋亚楠[1] 闫浩 陈约东[2] 谭谦[1] SHI Xiao-cheng;YU Peng-li;WANG Shu-qin;JIANG Ya-nan;YAN Hao;CHEN Yue-dong;TAN Qian(Department of Plastic Surgery,Drum Tower Clinical Medical College of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院烧伤整形科,江苏南京210008 [2]中国人民解放军第四五四医院骨科,江苏南京210003 [3]南京大学医学院附属鼓楼医院超声诊断科,江苏南京210008

出　　处：《中国美容整形外科杂志》2018年第10期623-626,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的应用彩色多普勒超声技术检测腓动脉穿支的分布规律和内径等参数并对其进行研究,进而探讨腓动脉穿支皮瓣的临床应用效果。方法应用彩色多普勒超声技术对15例健康志愿者双侧小腿30侧腓动脉的穿支数目、分布、类型及直径进行检测研究;术前对25例患者行腓动脉穿支精确定位并设计皮瓣修复缺损部位,术后观察不同类型腓动脉穿支皮瓣的临床效果。结果 15例志愿者双侧小腿30侧腓动脉的穿支总数为110支,其中肌皮穿支45支(占40.9%),肌间隙穿支65支(占59.1%);穿支起始处内径平均为(1.06±0.31)mm。25例患者应用腓动脉穿支皮瓣修复缺损,术后随访3～18个月,20例皮瓣完全成活,5例皮瓣出现局部坏死,其中3例采用皮肤移植修复后愈合,2例经换药后创面自愈。结论腓动脉穿支皮瓣具有稳定可靠的血管蒂,是重建软组织损伤的良好方法。Objective To explore the clinical application of the radial perforator flap by studying the distribution and radial diameter of the brachial artery perforation with Color Doppler ultrasonography. Methods Color Doppler ultrasonography was used to detect the number, distribution, type, and diameter of perforating branches of 30 radial arteries in 15 healthy volunteers. The perforating of the radial artery was accurately located in 25 patients by using ultrasound positioning technology and the designed flap. The clinical effects of different types of radial artery perforator flap were then observed. Results A total of 15 healthy volunteers（30 iliac arteries） were selected for this study. The total number of perforators was 110. Among them, 45 branches（40.9%） were musculocutaneous perforators and 65（59.1%） were septocutaneous perforators. The mean diameter at the beginning of the perforation was（1.06±0.31） mm. Twenty-five patients were followed up for 3 to 18 months. Partial flap necrosis occurred in 5 cases, 3 of which healed after secondary surgery by skin grafting.Conclusion The peroneal artery perforator flap is a good alternative for the reconstruction of soft tissue defects.

关 键 词：腓动脉穿支皮瓣 游离皮瓣 组织修复 超声技术 

分 类 号：R622[医药卫生—整形外科]