浅静脉干在远端蒂皮瓣中作用的逆向造影研究  

Aretrograde venography study on the role of large superficial veins in distally-based flaps

作　　者：张世民[1] 顾玉东[1] 李继峰[1] 

机构地区：[1]复旦大学附属华山医院手外科,上海200040

出　　处：《中国临床解剖学杂志》2004年第1期8-9,共2页Chinese Journal of Clinical Anatomy

基　　金：中国博士后科学基金资助项目 (2 0 0 2 0 31 1 76)

摘　　要：目的 :探讨浅静脉干在远端蒂筋膜皮瓣中的作用。方法 :在 5只新西兰大白兔掀起 10个远端蒂小隐静脉腓肠神经筋膜岛状皮瓣 ,对小隐静脉近端插管注射造影剂 ,动态观察造影剂的流向。结果 :放松止血带后 ,静脉血从足部 (爪 )倒灌入皮瓣 ,小隐静脉充盈扩张乃至怒张 ,造成静脉瓣膜相对关闭不全。在施加压力注射的情况下 ,造影剂发生逆向回流 ,去除压力 ,造影剂不再逆流。 1h后造影剂仍积聚于小隐静脉近端 ,部分扩散进入皮瓣中。结论 :浅静脉干近端流出道阻断后 ,在正常压力下管腔内血流未见逆向反流 ,但高压下可发生逆向回流。Objective: To investigate the role of large superficial veins in distally-based flap.Methods: Ten distally-based lesser saphenous sural veno-neuro-adipofasial pedicled fasciocutaneous flaps were raised in five New Zealand White rabbits.Retrograde venography of the lesser saphenous vein was performed and x-ray monitoring was carried out. Results: After flap elevation and tourniquet releasing, continuous blood filling from the paw to the lesser saphenous vein made it overdilated, and led venous valve regrugitant.After injection with manual pressure in the proximal end, reverse flow of radiopaque was observed in the lesser saphenous vein.If the manual pressure withdrawn, the reverse flow would stop.One hour later, x-ray film showed the radioaque were still accumulated at the proximal end of the lesser saphenous vein, and some retrogradely entered the flap. Conclusion: Reverse flow in large superficial veins in distally-based flaps can not occur under normal pressure, but can occur under high retrograde pressure.

关 键 词：外科皮瓣 远端蒂皮瓣 浅静脉 静脉回流 静脉逆向造影 

分 类 号：R616.2[医药卫生—外科学]