数字减影血管造影在腓动脉穿支皮瓣移植中的应用  

Application of digital subtraction angiography in peroneal artery perforator flap transplantation

作　　者：陈永沛 仲海燕 陈勇 王慜 王倩 邹鸣立 袁斯明 Chen Yongpei;Zhong Haiyan;Chen Yong;Wang Min;Wang Qian;Zou Mingli;Yuan Siming(Department of Burn and Plastic Surgery,Jinling Hospital,the Affiliated Hospital of Medical School of Nanjing University,General Hospital of Eastern Theater Command,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院东部战区总医院烧伤整形科,210002

出　　处：《中华损伤与修复杂志（电子版）》2023年第6期507-510,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：东部战区总医院2021年度院内课题(YYZD2021001)。

摘　　要：目的探讨数字减影血管造影(DSA)在腓动脉穿支皮瓣移植中的应用效果。方法回顾性分析2020年1月至2022年12月南京大学医学院附属金陵医院烧伤整形科采用腓动脉穿支皮瓣修复小腿中下段及足踝部创面的患者临床资料,共18例。术前行数字减影血管造影明确腓动脉走行、各穿支分布情况,结合超声多普勒探查及创面情况设计并转移皮瓣,供瓣区直接缝合或皮片移植修复。术后随访6~12个月,观察皮瓣、供瓣区外观及患肢功能恢复情况。结果DSA显示腓动脉自胫后动脉向下走行并沿途发出数条穿支,各穿支间相互连接形成血管网。术后移植皮瓣和供瓣区移植皮片成活。随访显示皮瓣外观、质地良好,患肢功能恢复。结论DSA能清晰显示腓动脉走行及穿支,结合超声多普勒探查指导皮瓣设计和移植,在腓动脉穿支皮瓣修复小腿中下段及足踝部创面中可取得良好效果。Objective To investigate the application effect of digital subtraction angiography in peroneal artery perforator flap transplantation.Methods The clinical data of 18 patients who underwent peroneal artery perforator flap from January 2020 to December 2022 in Department of Burn and Plastic Surgery,Jinling Hospital,the Affiliated Hospital of Medical School of Nanjing University were analyzed retrospectively.Before operation,digital subtraction angiography(DSA)was performed to determine the course of peroneal artery and the distribution of perforating branches.Then ultrasonic Doppler was used to assist the design of flap based on the wound condition.The flap was harvested and transferred to cover the wound.The donor site was repaired by direct suture or skin graft.The postoperative followed-up was performed in 6-12 months,focusing on the appearance of skin flap,donor site and functional recovery of affected limb.Results DSA showed the peroneal artery along with the posterior tibial artery and its perforating branches,which connected with each other to form a vascular network.The flaps and skin graft in donor site survived well.Follow-up showed that the appearance and texture of the flap were good,and the function of the affected limb recovered.Conclusion The DSA can clearly show the course and perforating branch of peroneal artery.Combinational use of DSA and ultrasonic doppler in guiding the design and transplantation of skin flap can achieve good results in the repair of wounds in the middle and lower leg,ankle and foot.

关 键 词：数字减影血管造影 腓动脉穿支皮瓣 移植 

分 类 号：R622[医药卫生—整形外科]