本文選題：腹壁淺動(dòng)脈 + 外科皮瓣��； 參考：《蚌埠醫(yī)學(xué)院》2011年碩士論文

【摘要】：目的：為腹壁淺動(dòng)脈皮瓣的臨床應(yīng)用提供解剖學(xué)依據(jù)并探討其在頭頸部修復(fù)中的意義。 方法:尸體解剖：解剖常規(guī)福爾馬林固定6個(gè)月以內(nèi)的成年尸體標(biāo)本10具，觀察并測(cè)量腹壁淺動(dòng)靜脈的起源、位置、管徑、走形、分支、分布及與周圍血管的共干關(guān)系等，并模擬手術(shù)切取皮瓣1例。影像解剖：對(duì)60例健康志愿者的雙側(cè)下腹壁行彩色多普勒超聲檢測(cè)，觀察、測(cè)量腹壁淺動(dòng)靜脈的出現(xiàn)率、管徑、走形及平均流速等，并做相關(guān)分析。查閱國(guó)內(nèi)外文獻(xiàn)，結(jié)合目前頭頸部缺損與修復(fù)的現(xiàn)狀，對(duì)該皮瓣在頭頸修復(fù)中的意義進(jìn)行探討并評(píng)價(jià)彩色多普勒超聲在檢測(cè)腹壁淺動(dòng)脈皮瓣血供中的應(yīng)用價(jià)值。 結(jié)果：人體解剖學(xué)研究的10具標(biāo)本中，1具2側(cè)腹壁淺動(dòng)脈缺如；9具18側(cè)標(biāo)本在腹股溝水平均可見腹壁淺動(dòng)脈，動(dòng)脈平均管徑為1.48mm,平均蒂長(zhǎng)為4.80cm。11側(cè)在起始處與周圍血管形成共干。腹壁淺動(dòng)脈走行與分支方式有4種，其中5側(cè)為總干型，3側(cè)為雙分支型，7側(cè)為單外側(cè)支型，3側(cè)為單內(nèi)側(cè)支型。僅有腹壁淺靜脈伴行8側(cè)，腹壁淺靜脈和一對(duì)動(dòng)脈伴行靜脈同時(shí)出現(xiàn)12側(cè)。10具20側(cè)標(biāo)本均可見腹壁淺靜脈，平均管徑2.33mm，，平均蒂長(zhǎng)為5.45cm。超聲多普勒檢測(cè)的60側(cè)正常人體下腹壁中，檢測(cè)到腹壁淺動(dòng)脈52側(cè)，顯示率：86.7%，余8側(cè)中，6側(cè)未檢測(cè)到該血管，2側(cè)檢測(cè)到可疑血管信號(hào)，但連續(xù)性不佳。60側(cè)腹壁淺靜脈均在腹股溝韌帶中點(diǎn)內(nèi)側(cè)檢測(cè)到，由于其壁薄，易受壓變形，未對(duì)管徑進(jìn)行測(cè)量。腹壁淺動(dòng)脈起源平均管徑（D1）為:1.73±0.22mm，越過(guò)腹股溝韌帶管徑（D2）為：0.81±0.16mm，收縮期流速為：23.08±6.83cm/s,阻力指數(shù)為：0.60±0.17。文獻(xiàn)報(bào)道臨床應(yīng)用療效滿意，成功率達(dá)96.5%。 結(jié)論：1、腹壁淺動(dòng)脈皮瓣可選擇性的應(yīng)用于頭頸部多種軟組織缺損修復(fù)。2、部分腹壁淺動(dòng)脈管徑較細(xì)，術(shù)者需要嫻熟的顯微吻合技術(shù)。3、超聲多普勒超聲能清晰的顯示及定位動(dòng)脈，可對(duì)皮瓣的術(shù)前篩選及設(shè)計(jì)提供準(zhǔn)確、科學(xué)的依據(jù)。
[Abstract]:Objective: to provide anatomic basis for the clinical application of superficial abdominal artery flap and to explore its significance in the repair of head and neck. Methods: autopsy: 10 adult cadavers were fixed with formalin for less than 6 months. The origin, location, diameter, shape, branch, distribution and relationship with peripheral vessels of superficial abdominal arteriovenous vessels were observed and measured. The flap was removed by simulated operation in 1 case. Image anatomy: color Doppler ultrasound was performed on the bilateral lower abdominal wall of 60 healthy volunteers. The occurrence rate, diameter, shape and average velocity of the superficial arteriovenous vessels of the abdominal wall were observed and analyzed. According to the current situation of head and neck defect and repair, the significance of this flap in head and neck repair was discussed and the value of color Doppler ultrasound in detecting blood supply of superficial abdominal artery flap was evaluated. Results: the superficial abdominal artery was found in 9 of the 10 specimens of 10 specimens studied by human anatomy. The average diameter of the artery was 1.48 mm. The average pedicle length was the 4.80cm.11 side at the beginning and the peripheral blood vessel formed a common stem. There were 4 types of transversal and branching modes of superficial abdominal artery, of which 5 sides were total trunk type, 3 sides were double branching type, 7 sides were single lateral branch type and 3 sides were single medial branch type. There were only 8 superficial veins in the abdominal wall, 12 superficial veins and a pair of arterial veins in 20 sides of 10 patients. The average diameter was 2.33 mm and the average pedicle length was 5.45 cm. The superficial abdominal artery was detected in 52 sides of 60 normal human lower abdominal walls by ultrasound Doppler, with a display rate of 86.7%, and no suspicious vessel signal was detected in 2 sides of the remaining 8 sides. However, the superficial veins of 60 sides of the abdominal wall were detected on the medial side of the midpoint of the inguinal ligament. The diameter of the tube was not measured because the wall was thin and easily deformed. The mean diameter of the origin of the superficial abdominal artery was 1.73 鹵0.22mm, the diameter of the inguinal ligament was 0.81 鹵0.16mm, the velocity of contraction was 0.23.08 鹵6.83cm / s, the resistance index was 0.60 鹵0.17mm. It is reported that the clinical application is satisfactory, and the success rate is 96. 5%. Conclusion the superficial abdominal artery flap can be selectively used to repair multiple soft tissue defects in head and neck, and the diameter of some superficial abdominal arteries is thin. The technique of microanastomosis is needed. Ultrasound Doppler ultrasound can clearly display and locate the artery. It can provide accurate and scientific basis for the preoperative screening and design of the flap.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R322

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 毛馳;俞光巖;彭歆;張雷;郭傳tx;黃敏嫻;張益;馬大權(quán);;頭頸部游離復(fù)合組織瓣移植的臨床研究[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2008年01期

2 陳爾瑜;何光篪;程耕歷;劉正津;;腹股溝區(qū)皮瓣的血管——二.腹壁淺動(dòng)脈和靜脈的巨微解剖[J];解剖學(xué)報(bào);1982年02期

3 張志愿,鄭家偉;口腔頜面部游離組織移植時(shí)受區(qū)血管的選擇與吻合技術(shù)[J];口腔頜面外科雜志;1999年02期

4 吳一民;曾俐敏;呂慧成;樊東升;溫樹正;;腹壁淺動(dòng)脈軸型皮瓣修復(fù)手部大面積組織缺損[J];實(shí)用手外科雜志;2005年04期

5 潘峰,陳振光,林海濱,謝昀,陶圣祥;髂腹股溝區(qū)血供的應(yīng)用解剖研究及其臨床意義[J];醫(yī)學(xué)新知雜志;2004年03期

6 陳建榮;孫建平;徐飛;;彩色多普勒超聲顯像在燒傷、整形外科中的應(yīng)用[J];中國(guó)超聲醫(yī)學(xué)雜志;2007年01期

7 李真華,周小紅,葛家華,胡開明,何云;前臂橈側(cè)游離皮瓣修復(fù)口腔頜面部軟組織缺損[J];中華耳鼻咽喉頭頸外科雜志;2005年09期

8 黎洪棉;高建華;梁自乾;劉達(dá)恩;張莉;;應(yīng)用彩色多普勒影像技術(shù)設(shè)計(jì)腹部軸型皮瓣修復(fù)手腕部深度創(chuàng)面[J];中華手外科雜志;2006年06期

9 張滌生;;顯微外科的歷史回顧和展望[J];中華顯微外科雜志;2006年01期

10 張彬,山田敦;頭頸部腫瘤術(shù)后缺損游離組織瓣的供區(qū)選擇[J];中國(guó)修復(fù)重建外科雜志;2005年10期

本文編號(hào)：1909045