本文選題：股前外側(cè)皮瓣　切入點：CT血管造影　出處：《臨床耳鼻咽喉頭頸外科雜志》2017年24期 　論文類型：期刊論文

【摘要】：目的:采用數(shù)字化技術(shù)對口腔頜面部軟組織缺損行術(shù)前皮瓣設(shè)計,指導(dǎo)手術(shù)操作,為制作個性化股前外側(cè)皮瓣提供依據(jù)。方法:選取7例患有口腔頜面部惡性腫瘤患者,行下肢薄層CT掃描,對CT血管造影檢查結(jié)果進(jìn)行數(shù)據(jù)分析,測量出旋股外側(cè)動脈降支穿支的管徑、走形、血管蒂長度,選取合適的穿支做為皮瓣血供來源,在皮膚上標(biāo)記穿支位置,模擬皮瓣切取范圍。術(shù)中根據(jù)術(shù)前標(biāo)記,畫線并標(biāo)出皮瓣大小,皮瓣制備完畢后,供區(qū)直接拉攏縫合,內(nèi)置負(fù)壓引流管。將皮瓣移植到組織缺損處,分別行動靜脈吻合,皮瓣與缺損創(chuàng)面嚴(yán)密縫合,頸部內(nèi)置負(fù)壓引流管,術(shù)后嚴(yán)密觀測皮瓣及全身狀況。結(jié)果:所有重建的旋股前外側(cè)動脈降支穿支皮瓣均能顯示皮膚、肌肉、血管及其毗鄰關(guān)系,并根據(jù)缺損區(qū)域大小,利用Mimics 17.0軟件模擬切取皮瓣,與缺損范圍基本一致。7例皮瓣主要穿支及主干與術(shù)前檢查一致,皮瓣全部成活,創(chuàng)面及供區(qū)均Ⅰ期愈合。術(shù)后隨訪1~6個月,皮瓣外形、質(zhì)地和功能均恢復(fù)良好。結(jié)論:利用數(shù)字化技術(shù)可以準(zhǔn)確定位旋股外側(cè)動脈降支穿支位置,顯示皮膚、肌肉、血管與骨骼之間空間關(guān)系,結(jié)合Mimics17.0軟件實現(xiàn)股前外側(cè)皮瓣三維化及精確化設(shè)計,減少供區(qū)損傷,提高皮瓣成功率。
[Abstract]:Objective: to design the preoperative flap for oral and maxillofacial soft tissue defects by digital technique, and to provide the basis for making individualized anterolateral femoral flap. Methods: seven patients with oral and maxillofacial malignant tumor were selected. Thin slice CT scanning of lower extremity was performed, and the data of CT angiography were analyzed. The diameter, shape and length of the perforating branch of descending branch of lateral circumflex femoral artery were measured. The appropriate perforating branch was selected as the blood supply source of the flap. The position of perforating branch was marked on the skin, and the range of skin flap was simulated. According to the mark before operation, the line was drawn and the size of the flap was marked. After the preparation of the flap, the donor area was closed and sutured directly, and the negative pressure drainage tube was built in. The flap was transplanted to the site of tissue defect. The flap was sutured to the defect wound, the negative pressure drainage tube was built in the neck, the flap and the whole body were observed closely after operation. Results: all the reconstructed perforators of the descending branch of anterolateral circumflex femoral artery could show the skin and muscle. According to the size of the defect area and the size of the defect area, the flap was simulated by Mimics 17.0 software. The results showed that the main perforating branch and trunk of the flap were consistent with the defect area, and all the flaps survived. The wound and donor area were healed in the first stage. The skin flap was followed up for 1 ~ 6 months. The shape, texture and function of the flap recovered well. Conclusion: the location of the descending branch of lateral femoral circumflex artery can be accurately located by digital technique, and the skin and muscle can be displayed. The three-dimensional and accurate design of anterolateral femoral flap was realized by using Mimics17.0 software to reduce the injury of donor area and improve the success rate of the flap.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬蘇州九龍醫(yī)院口腔頜面外科;西南醫(yī)科大學(xué)附屬醫(yī)院整形外科;蘇州市立醫(yī)院介入科;
【基金】：江蘇省青年醫(yī)學(xué)人才項目(No:QNRC2016232)
【分類號】：R782.2

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