腓动脉皮支血管为蒂的小腿外侧皮瓣吻合血管游离移植的解剖学与临床应用  

Anatomy and Clinical Application of Free Vascular Transplantation of Lateral Leg Flap Pedicled With Cutaneous Branch of Peroneal Artery

作　　者：牛龙洋 史建超 NIU Longyang;SHI Jianchao(Shijiazhuang People's Medical College,Shijiazhuang,Hebei,050091)

机构地区：[1]石家庄人民医学高等专科学校,河北石家庄050091

出　　处：《智慧健康》2022年第33期111-114,127,共5页Smart Healthcare

摘　　要：目的论腓动脉皮支血管为蒂的小腿外侧皮瓣吻合血管游离移植解剖的临床应用价值。方法对15具成人尸体进行解剖,解剖双侧的小腿,对小腿外侧腓动脉皮支的相关数据进行测量并做记录;再选择10例成人活体进行多普勒血管仪测量,观察双侧小腿外侧腓动脉皮支血管的穿出点;临床选取18例进行小腿外侧腓动脉皮支皮瓣吻合血管游离移植手术的患者作为研究对象,分析手术的情况。结果15具成人尸体解剖双侧小腿,可观察到皮支共130支,每侧有1~7支不等,平均4.33支。其中一侧只具备高位皮支1支,75.38%(98支)的皮支穿出点处于腓骨头最凸点下方(7~21cm)。每侧皮质动脉外径最粗(1.82±0.41)mm和(1.46±2.91)mm,两条伴行静脉的外径平均为(3.05±0.51)mm和(2.49±0.46)mm;10例成人活体检验可得,观测到小腿外侧皮支血管穿出点95个,每侧平均4.75个;临床上,18例患者切取的皮瓣面积为5.0×3.5~28~11(cm),且所有皮瓣均成活。结论人体小腿外侧的皮瓣主要有不同数量的腓动脉皮支所供养,主皮支可以为显微外科吻合血管手术提供可能,相对腓血管为蒂的小腿外侧游离皮瓣移植术,皮支血管为蒂的手术创伤小、操作简便,可更好的重建患者的生理血运。Objective To discuss clinical application value of free vascular transplantation of lateral leg flap pedicled with cutaneous branch of peroneal artery.Methods The paper dissected 15 adult cadavers,measured and recorded related data of cutaneous branch of lateral peroneal artery of lower leg;then chose 10 living adults for Doppler angiometer measurement and observed perforating points of cutaneous branches of bilateral lateral peroneal arteries in lower legs;chose 18 patients with free vascular transplantation of skin flap pedicled with cutaneous branch of lateral peroneal artery of lower leg as study subjects,operation conditions were analyzed.Results Based on bilateral crus anatomy of 15 adult cadavers,130 cutaneous branches were observed on both legs,ranging from 1 to 7 branches on each side,with average of 4.33 branches.There was only one high cutaneous branch on one side,and 75.38%(98 branches)of cutaneous branches protruded below convex point of fibular head(7-21cm).Diameter of each cortical artery was the thickest(1.82±0.41)mm and(1.46±2.91)mm,and diameter of two concomitant veins was(3.05±0.51)mm and(2.49±0.46)mm on average;Based on detection of 10 adult cadavers,95 perforating points of lateral cutaneous branches of lower leg were observed,with average of 4.75 on each side;Clinically,flap area of 18 patients was 5.0×3.5-28~11(cm),and all flaps survived.Conclusion Lateral skin flap of human lower leg is mainly supported by different numbers of cutaneous branches of peroneal artery.Main cutaneous branch can provide possibility for microsurgical vascular anastomosis.Compared with free flap of lateral leg pedicled with peroneal artery,flap pedicled with cutaneous branch can cause less trauma with easy operation,can reconstruct physiological blood supply of patients better.

关 键 词：腓动脉皮支血管 小腿外侧皮瓣吻合 血管游离 移植解剖 显微外科 

分 类 号：R658.3[医药卫生—外科学]