彩色多普勒超声在腓动脉穿支腓肠神经营养血管皮瓣中的应用效果  

The Application Value of Color Doppler Ultrasound in the Pedicled Peroneal Perforator-Sural Neurotrophic Vascular Flap

作　　者：陈琳[1] 王辉[2] 马铁鹏[2] 周彤[2] 刘英[1] Chen Lin;Wang Hui;Ma Tiepeng;Zhou Tong;Liu Ying(Department of Ultrasound,The Second Hospital of Tangshan,Tangshan,Hebei 063000,China;Department of Hand Surgery,The Second Hospital of Tangshan,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院超声科,河北省唐山市063000 [2]唐山市第二医院手外科,河北省唐山市063000

出　　处：《中国超声医学杂志》2025年第3期352-355,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨彩色多普勒超声在腓动脉穿支腓肠神经营养血管皮瓣逆行转移修复足踝部软组织缺损的术前应用效果。方法 选取唐山市第二医院手外科收治,运用腓动脉穿支腓肠神经营养血管皮瓣逆行转移修复足踝部软组织缺损患者18例,术前应用彩色多普勒超声,标记腓动脉优势穿支动脉穿深筋膜浅出点及腓肠神经。应用坐标法将穿出点标记于体表,并以坐标轴(x, y)方式书写于超声报告上。结果 18例患者术前应用彩色多普勒超声标记的腓动脉优势穿支动脉穿深筋膜浅出点位置及腓肠神经,术中均证实存在,超声准确度为100%。18例患者均成功实施手术,术后供区I期愈合,所有患者获得随访,随访9~33个月,平均19个月。皮瓣血运良好,颜色、质地与周围皮肤相近,肢体及皮瓣功能均恢复满意。结论 彩色多普勒超声可以直观地探测穿支动脉走行、穿深筋膜浅出点位置及皮神经,筛选出优势穿支动脉,为皮瓣设计切取提供可靠影像学依据。Objective To explore the preoperative application value of color Doppler ultrasound in the retrograde pedicled peroneal perforator-sural neurotrophic vascular flap for foot and ankle soft tissue defect.Methods Eighteen patients with soft tissue defects in foot and ankle who were treated by retrograde pedicled peroneal perforator-sural neurotrophic vascular flaps were selected.Color Doppler ultrasound was applied before the operation,marking the perforation point of the advantage peroneal perforator from the deep fascia and the sural nerve.Coordinate method was applied to mark the point on the skin surface and record it on the ultrasonic report by coordinate axis(x,y).Results The advantage peroneal perforator and sural nerve detected by color Doppler ultrasound in 18 patients were confirmed to exist in the operation,and the ultrasound accuracy rate was 100%.All the 18 patients were successfully operated on,and the donor sites were primary healing.All patients were followed up for 9-33 months,with an average of 19 months.The skin flap had good blood flow,the color and texture were similar to the surrounding skin,and the func-tion of the limb and flap recovered satisfactorily.Conclusions Color Doppler ultrasound can intuitively detect the run-ning of artery perforator,the perforation point from the deep fascia and the sural nerve,and the advantage peroneal perforator.It provid a reliable imaging basis for flap design and incision.

关 键 词：彩色多普勒超声 腓动脉穿支动脉 腓肠神经营养血管皮瓣 足踝部软组织缺损 

分 类 号：R658.3[医药卫生—外科学] R445.1[医药卫生—临床医学]