彩色多普勒超声对胫后动脉穿支血管的解剖学研究及临床应用  

Anatomical study and clinical application of perforating branch of posterior tibial artery by color Doppler ultrasound

作　　者：赵风林[1] 赵鸣宇 王鑫[1] 岳立明 马志国 ZHAO Fenglin;ZHAO Mingyu;WANG Xin(Department ofPlastic Surgery,The Third People's Hospital of Jinan,Shandong,Jinan,250132,China)

机构地区：[1]济南市第三人民医院整形外科,山东济南250132 [2]大连医科大学研究生院,辽宁大连116044

出　　处：《实用手外科杂志》2022年第1期56-58,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨应用彩色多普勒超声(CDU)探测胫后动脉穿支的解剖学分布规律进而指导临床应用。方法应用彩色多普勒超声探测双侧胫后动脉穿支的数目、分布、蒂长及外径,并结合解剖学观察结果设计皮瓣,用来修复手背、腕背等创面,自2016年7月临床应用24例,皮瓣面积:2.0 cm×4.0 cm~8.0 cm×12.0 cm。结果探测到外径≥0.5 mm的胫后动脉穿支274支,每侧平均5.7支,穿支血管在胫后动脉起始点的外径为(1.4±0.8)mm,穿支血管蒂长度(4.5±2.2)cm。24例皮瓣均完全成活,15例随访3~12个月,皮瓣质地柔软,受区功能、外形均满意,供区无并发症。结论彩色多普勒超声在胫后动脉穿支皮瓣术前设计方面作用显著,该皮瓣血供可靠,是修复中、小面积软组织缺损较好供区。Objective To detect the anatomical distribution of the cutaneous perforating branch of the posterior tibial artery by color Doppler ultrasound so as to guide the clinical application.Methods The number,distribution,pedicle length and external diameter of bilateral perforating branches of posterior tibial artery in 24 patients were detected by color Doppler ultrasonography.Combined with anatomical observation,a skin flap was designed to repair wounds such as the back of hand and wrist.24 cases were clinically applied,with the largest flap area of 8.0 cm×12.0 cm and the smallest 2.0 cm×4.0 cm.Results Two hundred and seventy-four perforators of the posterior tibial artery with an outer diameter of>0.5 mm were detected,with an average of 5.7 on each side.The outer diameter of the perforator at the origin of the posterior tibial artery was(1.4±0.8)mm,and the length of the pedicle of the perforator was(4.5±2.2)cm.All 24 flaps survived completely,and 15 of them were followed up for 3~12 months.The flaps were soft in texture,satisfactory in function and the shape of recipient area,and no complications occurred in the donor area.Conclusion Color Doppler ultrasound plays a significant role in the preoperative design of the perforator flap of the posterior tibial artery.The flap has reliable blood supply and is a good donor site for repairing medium and small soft tissue defects.

关 键 词：胫后动脉 彩色多普勒超声 游离皮瓣 穿支血管 

分 类 号：R445.1[医药卫生—影像医学与核医学] R622[医药卫生—诊断学]