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目的探讨胸背动脉穿支皮瓣的解剖学基础及其在头颈修复中的临床意义。方法解剖新鲜成人尸体5具,观察、测量胸背动脉穿支皮瓣供血穿支的数目、类型、管径、蒂长、走行、出筋膜后轴向及源血管外径,并对其定位。结果胸背动脉穿支44支,其中肌皮穿支35支、肌间隔/直接皮穿支9支。胸背动脉内侧支的肌皮穿支数占38.6%。胸背动脉外侧支的皮穿支数占54.5%,大部分位于背阔肌前缘2 cm之内。最粗穿支血管平均蒂长(12.41±2.84)cm。肩胛下动静脉外径(3.59±0.62)(、3.75±0.41)mm,胸背动静脉外径(2.71±0.43)(、2.98±0.18)mm。结论胸背动脉的穿支血管解剖位置较为恒定,穿支皮瓣制作方便,其管径及蒂长均适宜头颈肿瘤术后缺损的修复。
Objective To investigate the anatomic basis of thoracodorsal perforating skin flap and its clinical significance in head and neck repair. Methods Five fresh adult cadavers were dissected and the number, type, diameter, pedicle length of the perforating branches of the thoracodorsal artery perforating branches were measured and measured. The axial and source vessel diameters of the posterior fascia were measured and located . Results Thoracodorsal artery perforating branch 44, of which 35 cases of muscle skin wear, muscle space / direct skin wear branch 9. Thoracodorsalis medial branch of the muscle wear branch number accounted for 38.6%. Thoracodorsal artery lateral branch of the number of perforation accounted for 54.5%, most of the latissimus dorsi front within 2 cm. The average diameter of the pedunculated branch was (12.41 ± 2.84) cm. The subscapular arteriovenous diameter (3.59 ± 0.62) mm (3.75 ± 0.41 mm) and thoracic dorsal venous diameter (2.71 ± 0.43) mm (2.98 ± 0.18 mm). Conclusions The perforating branches of the thoracodorsal artery have a relatively constant anatomical position and the perforator flap is easy to make. The diameter and pedicle length of the thoracodorsal artery are suitable for the repair of postoperative head and neck neoplasms.