基于DSA的旋股外侧动脉斜支的形态学研究及其临床意义  

DSA of the oblique branch of lateral circumflex femoral artery:A morphological study and clinical significance

作　　者：杨林 程俊楠 刘胜哲 柳志锦 张韬 李雷[1] 巨积辉[1] YANG Lin;CHENG Junnan;LIU Shengzhe;LIU Zhijin;ZHANG Tao;LI Lei;JU Jihui(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215104,China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《中华显微外科杂志》2021年第6期642-646,共5页Chinese Journal of Microsurgery

基　　金：江苏省青年医学人才项目(QNRC2016224);江苏省研究生科研与实践创新计划项目(SJCX20_1076);苏州市姑苏卫生人才计划项目(2020075);苏州市民生科技项目关键技术应用研究(SS202092);苏州市卫生科教临床重点病种诊疗技术专项(LCZX202026);苏州市企业工程技术研究中心专项(SZS2019263)。

摘　　要：目的通过数字减影血管造影(DSA)观察旋股外侧动脉(LCFA)斜支的形态学特点,为应用以LCFA斜支为蒂的ALTF提供影像学依据。方法2020年2月至2020年12月,对113例需要ALTF修复创面患者术前定位的197侧DSA进行分析。观察LCFA斜支的出现率、发出点、走行等形态学特点,分析LCFA斜支与高位皮支、降支、横支等关系。同时,为印证DSA资料对斜支形态学特点描述的准确性随机选择10例10侧加做旋转DSA三维成像对DSA成像结果进行检测。结果197侧DSA造影股动脉、股深动脉、LCFA及各分支均清晰可辨,斜支出现在190侧,出现率为96%,其中发自股动脉1侧,发自股深动脉2侧,发自LCFA 187侧。10侧旋转DSA三维成像中均出现斜支,与所行DSA影像一致。结论利用DSA技术可以直观地分析LCFA斜支的出现率和形态学特点,斜支并非文献报道的变异分支,而是恒定出现,其有可能成为ALTF的主要供血动脉。Objective The morphological characteristics of the oblique branch of lateral circumflex femoral artery(LCFA)were observed by digital subtraction angiography(DSA)in order to provide imaging basis in the application of the ALTF pedicled with the oblique branch of LCFA.Methods Between February,2020 and December,2020,for the patients who were requested to repair the wound with ALTF,a DSA radiography was performed before operation.A total of 197 sides of selective DSA were analysed in 113 patients.The occurrence rate,origin and course of the oblique branch of LCFA were observed.Relationships between the oblique branch of LCFA and the upper cutaneous branch,descending branch and transverse branch were analysed.In addition,in order to verify the accuracy of conventional DSA data in describing the morphological characteristics of oblique branches,10 sites of 10 patients were randomly selected to perform rotational DSA three-dimensional imaging.Results Femoral artery,deep femoral artery,LCFA and the branches of LCFA were clearly identified on DSA images.The oblique branch appeared in 190 sites,with a occurence rate of 96%.Among them,1 oblique branch originated from the femoral artery,2 from the deep femoral artery,and other 187 from LCFA.The oblique branches were found in 10 sites from rotational DSA three-dimensional imaging,which was consistent with conventional DSA imaging.Conclusion The occurrence rate and morphological characteristics of the oblique branch of LCFA can be directly analysed by DSA.The oblique branch is not a variant branch as reported in the literatures,as it always appears.It may serve the main blood supply artery of the anterolateral thigh flap.

关 键 词：斜支 旋股外侧动脉 数字减影血管造影 股前外侧皮瓣 穿支皮瓣 应用解剖 

分 类 号：R658.2[医药卫生—外科学]