利用腹壁浅动静脉超灌注回流挽救腹壁下动脉穿支皮瓣罕见血运不良的乳房再造1例  

Rare falp dysvascularization salvaged by superficial inferior epigastric vessels supercharge/drainage:a case of deep inferior epigastric perforator flap breast reconstruction

作　　者：马小睦 徐伯扬 刘温悦 李尚善 陈兆瀚 杜星仪 刘春军 Ma Xiaomu;Xu Boyang;Liu Wenyue;Li Shangshan;Chen Zhaohan;Du Xingyi;Liu Chunjun(Department of Breast Comprehensive Plastic Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院乳腺综合整形科,北京100144

出　　处：《中华整形外科杂志》2023年第4期390-394,共5页Chinese Journal of Plastic Surgery

基　　金：中国医学科学院临床与转化医学研究基金(2020-I2M-C&T-B-082)。

摘　　要：在腹壁下动脉穿支皮瓣乳房再造中,非血管蒂原因如深浅静脉系统之间缺乏有效连通所致的皮瓣弥漫性淤血十分罕见。该文报道了1例乳腺癌术后行腹壁下动脉穿支皮瓣乳房再造的32岁女性,影像学提示双侧腹部均缺乏优势的腹壁下动脉穿支,且深浅静脉系统间缺乏交通。术中提前解剖腹壁浅动静脉备用,术中行吲哚菁绿血管造影提示皮瓣动脉灌注不足和静脉淤血,利用预留的腹壁浅动静脉进行超灌注回流成功挽救了皮瓣,最大限度地保留了该年轻患者的腹壁功能。In deep inferior epigastric perforator(DIEP)flap breast reconstruction,diffuse venous congestion caused by non-pedicle causes,such as lack of effective communication between deep and superficial venous systems,is very rare.In this paper,a case of young woman who underwent DIEP breast reconstruction after breast cancer mastectomy was reported.Imaging findings showed the absence of bilateral dominant perforators and the lack of communication between the deep and superficial venous system.During operation,the superficial inferior epigastric vessels were dissected in advance.Indocyanine green angiography showed arterial perfusion insufficiency and venous congestion.The flap was successfully salvaged by supercharging/draining with superficial inferior epigastric vessels,preserving the abdominal function of the young patient to the greatest extent.

关 键 词：外科皮瓣 腹壁下动脉穿支皮瓣 乳房再造 腹壁浅静脉 腹壁浅动脉 

分 类 号：R655.8[医药卫生—外科学]