颏下皮瓣动脉网构筑的显微外科解剖  

Microsurgical anatomy of the arterial network of submental flap

作　　者：花先 丁冉[2] 柯俊仪 丁自海[2] 刘鹏 郑雪峰 HUA Xian;DING Ran;KE Junyi;DING Zihai;LIU Peng;ZHENG Xuefeng(Department of Human Anatomy,Henan Vocational College of Nursing,Anyang,Henan Province 455000,China;Department of Human Anatomy,Southern Medical University,Guangzhou 510515,China;Department of Plastic Surgery,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Human Anatomy,Basic Medical College of Ji’nan University,Guangzhou 510632,China)

机构地区：[1]河南护理职业学院人体解剖学教研室,河南安阳455000 [2]南方医科大学人体解剖学教研室,广州510515 [3]广州市红十字会医院整形外科,广州510220 [4]暨南大学基础医学院人体解剖学教研室,广州510632

出　　处：《中华显微外科杂志》2021年第1期56-59,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金(31171153,31271286)。

摘　　要：目的为颏下皮瓣移植提供更精准的颏下动脉走行、分支、分布、动脉网构筑及皮瓣切取范围的显微外科解剖学资料。方法2015年3月至2020年3月,采用36例成人头颈部新鲜标本制成血管铸型标本(72侧),向双侧颈外动脉内注入红色丙烯晴-丁二烯-苯乙烯(ABS)填充剂,观测颏下动脉的走行、分支、分布和动脉网的构筑特点。结果颏下动脉由面动脉距下颌骨下缘(1.50±0.50)cm处发出,起始处直径(1.50±0.85)(0.6~2.3)mm。颏下动脉主干长(5.5±0.5)cm,沿下颌骨下缘稍后方向前走行,沿途发出(9.0±3.0)(7~13)条分支,直径0.1~0.5 mm,主要分布于颏下区皮肤和浅筋膜。主干行至距下颌骨中线3.0 cm范围内分为升支、水平支和降支,升支1~5条,向上越过下颌骨下缘与下唇弓分支吻合,或参与构成下唇弓;水平支1~2条,向内又分为数支与对侧分支吻合;降支1~3条,行向后下方,与舌动脉和甲状腺上动脉的分支吻合。在颏下区,颏下动脉各分支间及与周边动脉的分支间相互吻合,构筑成密集的1~3层颏下动脉网,主网区范围约7.0 cm×5.0 cm,网内主要血管直径0.1~0.2 mm。结论颏下动脉主干较长,分支较多,分支间吻合丰富,构成密集的颏下动脉网,为颏下皮瓣提供了足够的蒂长、丰富的血供和切取面积,该皮瓣既可进行游离移植,也可转位移植。颏下皮瓣最佳切取部位为动脉网近中线区,切取面积以7.0 cm×5.0 cm为宜。Objective To provide microsurgical anatomy data in the course,branch,distribution,arterial network profile of the submental artery and the range of the flap excision in submental flap transplantation.Methods From March,2015 to March,2020,a total of 36 head and neck cast specimens were studied.Acrylic-butadience-styrene plastic(ABS)filler were perfused into the external carotid artery to make cast specimens.The course,branching,distribution and the arterial framework of the submental artery under a surgical microscope were investigated.Results The submental artery originated from the facial artery before reaching the lower edge of the mandible(1.50±0.50)cm,with a diameter of(1.50±0.85)(0.6-2.3)mm.The main trunk of submental artery was(5.5±0.5)cm in length,which ran forward along the lower edge of the mandible and branched out(9.0±3.0)(7-13)branches with diameters between 0.1-0.5 mm,and mainly distributed to skin and superficial fascia of the submental area.The main trunk of submental artery divided into ascending,horizontal and descending branches about 3.0 cm of the midline of the mandible.The ascending branch went upwards over the lower edge of the mandible and joined up with the lower labial arch or participated in the formation of the lower labial arch;the horizontal branch divided into several branches and joined up with the branches from the opposite side;the descending branch branched posteriorly and inferiorly,joined up with branches of lingual artery and superior thyroid artery.The branches of the submental artery and the branches of the peripheral arteries were joined up in the submental area to form the submental artery network.The diameter of the vessels in the network ranged 0.1-0.2 mm.The arterial network was built in the form of 1 to 3 layers,and the area of main network was about 7.0 cm×5.0 cm.Conclusion The submental artery has a long trunk,many branches and abundant anastomoses between the branches,forming a dense submental artery network,which provides sufficient pedicle length,rich blood s

关 键 词：颏下动脉 颏下皮瓣 动脉铸型 显微外科解剖 

分 类 号：R782.2[医药卫生—口腔医学]