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目的为股前内侧穿支皮瓣的临床应用提供解剖学基础。方法新鲜成人尸体20具(40侧),行一次性全身乳胶灌注5具,全身动脉造影15具。通过直接层次解剖,应用图像分析和测量系统Scion image,对股前内侧穿支进行定性、定量分析;螺旋CT扫描数据以Dicom格式输入Mimics图像工作站对该区穿支皮瓣进行三维重建。结果股前内侧区共有外径≥0.5mm的穿支(21.0±4.0)支,外径(0.8±0.1)mm,蒂长(4.5±2.1)cm,穿支的平均供血面积(44±4.8)cm2。将股前内侧区分为上、中、下3区,发现三个区域均有穿支供应相应区域皮肤,中1/3区是穿支分布最集中的区域,多为肌皮穿支,主要由股动脉主干,旋股外侧动脉起始部,以及膝降动脉的穿支供血。结论股前内侧区穿支丰富,穿支蒂的来源因解剖部位而不同,在中1/3区穿支出现率较为恒定,设计股前内侧穿支皮瓣是切实可行的。
Objective To provide an anatomical basis for the clinical application of medial perforator flaps. Methods Twenty fresh adult cadavers (40 sides) were subjected to one-time whole-body latex infusion of 5 and systemic arteriography. Through the direct hierarchical anatomy and the application of image analysis and measurement system Scion image, qualitative and quantitative analysis of the medial femoral perforation was carried out. The spiral CT scan data were input into the Mimics image workstation in Dicom format to reconstruct the perforator flap in this area. Results The medial femoral area had a total diameter of (21.0 ± 4.0) mm, an outer diameter of (0.8 ± 0.1) mm, a length of (4.5 ± 2.1) cm and an average area of blood supply of 44 ± 4.8 mm cm2. The medial anteroposterior area is divided into upper, middle and lower 3 areas, found that there are three regions perforating branches supply the corresponding region of the skin, 1/3 area is the distribution of perforating branches most concentrated region, mostly myocutaneous perforating branches, mainly by Femoral artery, spinous process, the beginning of the lateral artery, and the perforation of the knee artery descending artery blood supply. Conclusions The anterior medial femoral head is rich in perforation, and the origin of perforating peduncles is different due to the anatomic site. The incidence of perforating branches in the middle 1/3 zone is relatively constant. It is practicable to design the medial perforator flap.