Flow-through胫后动脉穿支皮瓣在保肢治疗中的临床应用  

Clinical application of Flow-through posterior tibial artery perforator flap in limb salvage treatment

作　　者：周树萍 宋力[1] 尹永涛 张广超 宋德恩 幸超峰[1] 周明武[1] 江小萌 张小亚 ZHOU Shuping;SONG Li;YIN Yongtao(Department of Trauma Orthopedics,988th Hospital of the Joint Logistics Support Force of PLA,Zhengzhou,Henan,450052,China)

机构地区：[1]中国人民解放军联勤保障部队第988医院创伤显微外科,河南郑州450052 [2]新郑市人民医院人民路院区外六科,河南新郑233015

出　　处：《实用手外科杂志》2020年第3期281-283,313,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨Flow-through胫后动脉穿支皮瓣修复肢体软组织合并长段主干血管缺损的临床疗效。方法对2014年6月-2019年6月收治的16例肢体软组织缺损并长段主干血管缺损患者采用胫后动脉穿支皮瓣修复创面,游离胫后动脉以及伴行静脉、大隐静脉修复肢体血管缺损。供区行植皮修复。结果术后皮瓣顺利成活,受区及供区创面均一期愈合,患肢恢复良好血液循环。16例均获得随访,随访时间6~24个月(平均12个月)。所有患者患肢均未出现缺血疼及肌肉萎缩,行血管彩超检查修复血管通血良好;皮瓣质地柔软,弹性可,患肢功能可。结论Flow-through胫后动脉穿支皮瓣可有效修复患肢创面,同时修复肢体主干血管长段缺损,重建患肢血液循环,是临床治疗严重肢体损伤、保肢治疗的有效方法之一。Objective To investigate the clinical effect of Flow-through posterior tibial artery perforator flap in the repair of limb soft tissue wtith long segment defects of main artery.Methods Between June2014 and December 2019,16 patients with limb soft tissue with long segment main vascular defects was repaired by using posterior tibial perforator flap,the posterior tibial artery and the accompanying vein and saphenous vein were used to repair the limb vascular defect.The defects on the donor sites were closed by medium thick skin graft.Results All the flaps were survival without infection and vascular crisis,the wounds of recipient and donor sites healed at first intention,and the blood circulationt of injured limb was restored well.The patients were followed up from 6 to 24 months(mean,12 months).The injured limb of patients had no ischemic pain and muscle atrophy.And the examination of Vascular Color Doppler Examination showed that the blood circulationt of main blood vessel flowed well.The flap was soft and elastic,and the function of injured limb recovered well.Conclusion The Flow-through posterior tibial artery perforator flap can effectively repair the wound of the affected limb,and repair the long segment defects of main vessels,reconstruct the blood circulationt of injured limb at the same time.The Flow-through posterior tibial artery perforator flap is an reliable and ideal method for reconstruction of complex wounds in the limbs with long segment main vessels.

关 键 词：胫后动脉穿支皮瓣 保肢 创面修复 主干血管修复 

分 类 号：R658.3[医药卫生—外科学]