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目的为尺动脉穿支皮瓣的临床应用提供解剖学依据。方法观察10具动脉铸型标本。取新鲜成人尸体25具(50侧),行一次性全身动脉造影。通过直接层次解剖,应用图像分析和测量系统Scion image,对前臂内侧区穿支进行定性、定量分析;螺旋CT扫描数据以Dicom格式输入Mimics图像工作站,对尺动脉穿支皮瓣进行三维重建。结果该区共有外径≥0.5mm的穿支(7.0±2.0)支,外径(0.6±0.2)mm,蒂长(2.7±1.4)cm,单穿支的供血面积(26.0±7.0)cm2。尺动脉除在远端发出粗大的尺动脉腕上皮支,在肱骨内上髁以下8~10cm处也有较粗、恒定的穿支,尺动脉多个穿支相互吻合形成前臂内侧血管链。结论可以尺动脉近端穿支为基础设计游离皮瓣,以内侧血管链为基础设计长而窄的增压穿支皮瓣也是切实可行的。
Objective To provide an anatomical basis for the clinical application of ulnar ulnar flaps. Methods Ten specimens of arteries were observed. Take fresh adult carcass 25 (50 sides), line one-time whole body arteriography. Through the direct hierarchical anatomy and the image analysis and measurement system Scion image, the perforation of the medial forearm was qualitatively and quantitatively analyzed. The spiral CT scan data was input into the Mimics image workstation in Dicom format and the ulnar artery perforator flap was reconstructed in three dimensions. Results A total of 7.0 ± 2.0 mm diameter branches with an outer diameter of 0.6 ± 0.2 mm and a pedicle length of 2.7 ± 1.4 cm and a mean diameter of 26.0 ± 7.0 cm 2 were obtained. In addition to the ulnar artery at the distal fat artery rupture of the ulnar artery, in the humeral medial epicondyle 8 ~ 10cm below also have thick, constant perforation, ulnar artery multiple perforating branches mutual anastomosis to form the medial forearm vascular chain. Conclusion The free flaps can be designed based on the proximal perforator of the ulnar artery. It is feasible to design long and narrow superficial perforator flaps based on the medial vasculature.