本文關(guān)鍵詞：股深動脈第三穿動脈游離皮瓣的應(yīng)用解剖學(xué)研究　出處：《吉林大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 股深動脈第三穿動脈 穿支皮瓣 游離組織移植 解剖與臨床

【摘要】：四肢軟組織缺損作為手外科及整形外科的常見病及疑難病,如今受到越來越多的重視,臨床上通常選擇植皮或者皮瓣移植術(shù)進(jìn)行修復(fù)。相對于植皮術(shù)來講,皮瓣移植術(shù)以其質(zhì)地好,有恒定的血供,不僅可覆蓋肌腱、骨骼外露的皮膚缺損,并且外形和功能滿意,因此常作為修復(fù)四肢軟組織缺損的首選術(shù)式。 股后區(qū)一直被認(rèn)為是開發(fā)新型游離皮瓣的良好供區(qū)。此處皮動脈大多數(shù)來自股深動脈分支,包括旋股內(nèi)、外側(cè)動脈及穿動脈；另外胭動脈及膝上內(nèi)、外側(cè)動脈也部分參與股后皮膚的血供,各動脈穿支進(jìn)入皮下組織后,相互交匯呈網(wǎng)狀結(jié)構(gòu),保證了軟組織的充分血供,且該處血管較為恒定,管徑較粗,供血范圍大,有伴行靜脈,因此以該處作為供區(qū)設(shè)計游離皮瓣具有可行性。 本文通過對10側(cè)成人下肢標(biāo)本的解剖學(xué)研究,對股深動脈第三穿動脈的起止、走行、分支、外徑、伴行靜脈、供血范圍、體表定位等進(jìn)行系統(tǒng)觀測及分析,以此支做血管蒂設(shè)計游離皮瓣,為四肢軟組織缺損的修復(fù)提供一種新的修復(fù)方法。 研究表明,股深動脈第三穿動脈發(fā)自股深動脈,起點(diǎn)距股骨內(nèi)外髁連線中點(diǎn)以近117.65+4.66mm,起點(diǎn)外徑1.658±0.15mm,發(fā)出后沿半膜、半腱肌與股二頭肌肌間隙向股后外側(cè)走行,于半膜、半腱肌和股二頭肌之間分支形成升支及降支,升支起點(diǎn)外徑0.73±0.06mm,穿出深筋膜后形成皮支,皮支起點(diǎn)距股骨內(nèi)外髁連線中點(diǎn)以近110.39±4.82mm,外徑為0.73+0.06mm。降支起點(diǎn)外徑為0.826±0.05mm,向遠(yuǎn)端自然延伸。股深動脈第三穿動脈皮支有兩條伴行靜脈,兩靜脈于皮支近端匯合到股深動脈第三穿動脈伴行靜脈,其外徑為1.12+0.22mm。 根據(jù)實(shí)驗(yàn)測得數(shù)據(jù),可設(shè)計以股深動脈第三穿動脈為血管蒂,股后區(qū)皮膚為供區(qū)的游離皮瓣：該皮瓣以股骨內(nèi)外髁中點(diǎn)連線以近110.00 mm處為軸心點(diǎn),股后中線為軸心線,切取范圍為26cm×9cm。本研究設(shè)計的皮瓣為四肢軟組織缺損提供了一種新的修復(fù)方法,具有血管蒂恒定,外徑粗,供皮面積大等優(yōu)點(diǎn),具有一定的臨床應(yīng)用及推廣價值。
[Abstract]:The soft tissue defects of limbs as hand surgery and plastic surgery of the common diseases and difficult diseases, now has received more and more attention in clinical, usually choose skin graft or flap transplantation for repair. Compared with skin grafting, skin flap transplantation with its good texture, there is a constant blood supply, can not only cover the tendon, bone exposed skin the defect, and satisfactory appearance and good function, so often as the preferred method for repairing soft tissue defects of the extremities.
The posterior thigh has been considered to be good for the development of new district. The cutaneous artery flap from the branches of the deep femoral artery, including femoral circumflex artery and perforating artery, the lateral popliteal artery in the knee; in addition, the blood supply of skin lateral artery also take part in the stock after the perforating artery into the subcutaneous tissue after each other the intersection forms network structure, to ensure adequate blood supply of soft tissue, and the blood vessel is constant, larger diameter, blood flow range, with accompanying vein, so as for the design of free flap is feasible.
This paper through anatomical study on 10 adult lower limb specimens of deep femoral artery perforating artery, third of the starting and ending, walking, branch diameter, concomitant vein, blood supply range, observation and analysis system for surface positioning, in order to do vascular pedicle flap design, provide a new method for the repair of repair the soft tissue defect of extremities.
The research shows that the deep femoral artery third perforating artery from the deep femoral artery, the femoral condyle from the starting point at the midpoint of the starting point 117.65+4.66mm, diameter 1.658 + 0.15mm, issued along the semi membrane, semitendinosus and biceps muscle gap to the shares of two shares after the lateral walking, half film formed between the semitendinosus and branches unit two biceps ramus and descending ramus starting point diameter 0.73 + 0.06mm, through deep fascia formed after cutaneous branches and cutaneous branches of the femoral condyle from the starting point at the midpoint of the 110.39 + 4.82mm, diameter 0.73+0.06mm. descending starting point diameter was 0.826 + 0.05mm, distal to the natural extension of the deep femoral artery. Third perforating artery skin a two accompanying veins, vein in two cutaneous branches of the proximal to the confluence of the deep femoral artery third perforating artery accompanying vein, the outer diameter is 1.12+0.22mm.
According to the measured data, can be designed to the deep femoral artery third perforating artery as the pedicle skin flap for posterior femoral free: the flap in the femoral condylar midpoint was nearly 110 mm as the axis, the axis line shares, cut the scope of 26cm * 9cm. the research design flap for soft tissue defect provides a new repairing method has constant vascular pedicle diameter, thick, for the advantages of large area skin, has certain clinical application and popularization value.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R322

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