CTA联合彩色超声多普勒下股前外侧分叶穿支皮瓣修复四肢组织缺损  

Repair of limb tissue defects with anterolateral femoral lobulated perforator flap assisted by CTA and color Doppler ultrasound

作　　者：王成德[1] 王爱[2] 马文国[2] 张焕起 王建国 Wang Chengde;Wang Ai;Ma Wenguo;Zhang Huanqi;Wang Jianguo(Department of Interventional Therapy,Yidu Central Hospital of Weifang,Weifang 262500,China;Department of Burn Plastic Surgery,Yidu Central Hospital of Weifang,Weifang 262500,China;Department of Orthopedics,Qingzhou Hospital of Traditional Chinese Medicine,Weifang 262500,China)

机构地区：[1]潍坊市益都中心医院介入治疗科,潍坊262500 [2]潍坊市益都中心医院烧伤整形外科,潍坊262500 [3]山东省青州市中医院骨科,潍坊262500

出　　处：《中华手外科杂志》2022年第2期111-113,共3页Chinese Journal of Hand Surgery

基　　金：潍坊市卫生健康委员会科研项目(wfwsjk_2019_145)。

摘　　要：目的探讨术前CTA联合彩色超声多普勒技术辅助下采用游离股前外侧分叶穿支皮瓣修复四肢软组织缺损的临床疗效。方法自2015年3月至2020年5月我科采用游离股前外侧分叶穿支皮瓣修复四肢软组织缺损创面13例。比较术前彩色超声多普勒定位和术中实际发现的穿支血管数目、位置及管径粗细。末次随访采用中华医学会手外科学会上肢部分功能评定试用标准评价患肢功能。结果皮瓣区域内术前通过彩色多普勒超声检测到32支穿支血管,术中实际找到33支,术前定位检查的阳性预测率达90.63%,敏感率达87.88%。术后13例皮瓣全部存活,随访6~24个月,末次随访评价患肢功能:优5例,良6例,可2例。结论游离股前外侧分叶穿支皮瓣术后供区可直接缝合,是修复四肢大范围软组织缺损的理想方法之一。术前CTA联合彩色超声多普勒技术可明确供区血管解剖结构,指导手术方案的设计及实施,缩短了手术时间,降低了手术风险。Objective To investigate the clinical efficacy of preoperative CTA combined with color Doppler ultrasound in repairing soft tissue defects of limbs with free anterolateral femoral lobulated perforator flap.Methods From March 2015 to May 2020,13 cases of soft tissue defects of limbs were repaired with free anterolateral femoral perforator flap.The number,location and diameter of perforating vessels were compared between preoperative color Doppler ultrasound localization and actual intraoperative findings.In the last follow-up,the upper limb function was evaluated by the trial standard of upper limb function evaluation issued by Hand Surgery Society of Chinese Medical Association.Results Thirty-two perforating vessels were detected by color Doppler ultrasound in the flap area before operation,and 33 were found during operation.The positive prediction rate of preoperative localization was 90.63%and the sensitivity rate was 87.88%.All the 13 flaps survived and were follow-up for 6 to 24 months.The function of the affected limb was evaluated in the last follow-up:excellent in 5 cases,good in 6 cases and fair in 2 cases.Conclusion The anterolateral femoral perforator flap can be sutured directly after operation,which is one of the ideal methods to repair large-scale soft tissue defects of limbs.The preoperative CTA combined with color Doppler ultrasound can clarify the anatomical structure of donor vessels,guide the design and implementation of surgical scheme,shorten the operation time and reduce the operation risk.

关 键 词：外科皮瓣 四肢 CT血管造影 彩色超声多普勒 

分 类 号：R658[医药卫生—外科学]