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在手术显微镜下,解剖了成人尸体50侧,对胸内侧区皮瓣血管源进行了研究。胸廓内动脉在上4个肋间隙发出的穿动脉中,以第Ⅱ穿动脉的出现率最高,平均管径最粗,分布面积也最大。进行胸内侧皮瓣吻合血管移植时,宜首选第Ⅱ穿动脉作为血管蒂。第Ⅰ穿动脉的分布面积和中心分布区,均大于第Ⅲ或第Ⅳ穿动脉,是第二选择。胸廓内动脉跨越了几个肋间隙,其中,第2肋间隙位置较浅,距胸骨缘较远,较其他肋间隙宽,这些有利于以第Ⅱ穿动脉,甚至连同一段胸廓内动脉,作为皮瓣血管蒂的采取。如果切除一段第2肋软骨,以胸廓内动脉连同第Ⅰ、Ⅱ穿动脉为血管蒂,可以扩大皮瓣的采取范围。根据穿动脉的起源、位置、管径、浅出点、行程、分布区范围和吻合情况等,讨论了采取吻合血管胸内侧皮瓣时应注意的问题。
Under a surgical microscope, 50 adult cadaveric bodies were dissected and vascular sources of the thoracic region were studied. Thoracic artery in the last four intercostal space issued through the arteries, the second highest incidence of perforating arteries, the average diameter of the coarsest, the distribution area is also the largest. Thoracic flaps for anastomosis vascular graft, the first choice should be the second perforating artery as the pedicle. The distribution area and central distribution area of the first perforating artery were larger than those of the third or the fourth perforating artery and were the second choice. The internal thoracic artery spans several intercostal spaces, where the second intercostal space is shallow and farther from the sternal margin than other intercostal space, which facilitates the insertion of the second perforating artery, even with a section of the internal thoracic artery, Petal pedicle to take. If the removal of a costal cartilage 2, to the thoracic artery with the first, Ⅱ perforating arteries for pedicle, you can expand the scope of the flap. According to the origin, location, diameter, shallow point, stroke, distribution range and anastomosis situation of perforator artery, the problems that should be paid attention to in order to fit the thoracic medial flaps of the blood vessel are discussed.