本文選題：應(yīng)用解剖 + 穿支皮瓣��； 參考：《南華大學(xué)》2010年碩士論文

【摘要】： 第一章腓腸內(nèi)側(cè)動脈穿支皮瓣的應(yīng)用解剖研究 目的了解腓腸內(nèi)側(cè)動脈發(fā)出肌皮穿支的數(shù)目、區(qū)域、類型、外徑,為腓腸內(nèi)側(cè)動脈穿支皮瓣的臨床應(yīng)用提供解剖學(xué)依據(jù)。 方法選取6側(cè)新鮮中國成人下肢標本進行顯微解剖研究,系統(tǒng)觀測腓腸內(nèi)側(cè)動脈的穿支數(shù)量、外徑、蒂長、起始部外徑、穿出點距乆皺褶及小腿后正中線的垂直距離,測量數(shù)據(jù)采用SPSS11.0統(tǒng)計軟件分析處理。 結(jié)果6側(cè)下肢標本共觀測到腓腸內(nèi)側(cè)動脈肌皮穿支13支,每側(cè)1～3支,平均2.2支,其中由腓腸內(nèi)側(cè)動脈前支發(fā)出的有4支(31%),由后支發(fā)出的有9支(69%)。穿支穿出點位于距乆皺褶以遠6.5～16.0cm、距后正中線1～4.5 cm,第一穿支距乆皺褶垂直距離平均為8.82±1.21 cm,距后正中線2.23±0.64 cm。起始部外徑平均為外徑2.52±0.35mm,穿支穿深筋膜處的外徑平均為0.81±0.1mm。 結(jié)論腓腸內(nèi)側(cè)動脈穿支恒定,攜帶源動脈能獲得較長的血管蒂,有理想的血管吻合口徑,具備游離移植及帶蒂轉(zhuǎn)移所要求的解剖學(xué)特點。 第二章腓腸內(nèi)側(cè)動脈穿支皮瓣的臨床研究 目的探討腓腸內(nèi)側(cè)動脈穿支皮瓣修復(fù)四肢皮膚軟組織缺損的可行性,并分析其臨床療效。 方法選擇2008年6月至2009年10月收治的四肢中小面積皮膚軟組織缺損患者10例,采用腓腸內(nèi)側(cè)動脈穿支皮瓣移植修復(fù)。其中游離移植修復(fù)8例,皮瓣面積5cm×4cm～16cm×8cm;帶蒂轉(zhuǎn)移修復(fù)2例,皮瓣面積7cm×5cm～10cm×6cm。術(shù)后3個月、6個月、9個月、12個月隨訪,觀測皮瓣外形、血運、穩(wěn)定性、感覺恢復(fù)情況、供區(qū)的外觀及運動功能。 結(jié)果本組10例皮瓣,9例順利成活,1例皮瓣下積血出現(xiàn)靜脈危象,經(jīng)清除積血引流處理后危象解除,皮瓣成活。皮瓣受區(qū)和供區(qū)創(chuàng)面均一期愈合。術(shù)后隨訪3～12個月(平均8個月),1例稍臃腫,9例不臃腫,皮瓣色澤正常,質(zhì)地柔軟,無一例發(fā)生潰瘍,感覺恢復(fù)到S2。7例皮瓣供區(qū)遺留線性疤痕,3例遺留植皮疤痕,肢體活動無影響。 結(jié)論腓腸內(nèi)側(cè)動脈穿支皮瓣薄而柔軟,皮瓣受區(qū)外形較美觀,供區(qū)創(chuàng)傷小,游離移植適合修復(fù)四肢中小面積皮膚軟組織缺損,帶蒂轉(zhuǎn)移適用修復(fù)膝部和小腿上段中小面積皮膚軟組織缺損。
[Abstract]:The applied anatomical study of perforating branch flap of medial sural artery Objective to investigate the number, region, type and external diameter of cutaneous perforators from medial sural artery, and to provide anatomic basis for clinical application of perforating branch flap of medial sural artery. Methods six fresh Chinese adult lower limb specimens were selected for microanatomical study. The number of perforating branches, external diameter, pedicle length, external diameter of the medial sural artery, the external diameter of the initial part, the distance between the puncture points and the fold and the vertical distance of the median line after the calf were observed systematically. The measurement data were analyzed and processed by SPSS11.0 statistical software. Results A total of 13 musculocutaneous perforators of medial sural artery were observed in 6 lower extremities, with an average of 2.2 branches per side. Four of them were from the anterior branch of the medial sural artery and 9 from the posterior branch. The perforating point was located at the distance of 6.5 ~ 16.0 cm from the pleated body, 1 ~ 4.5 cm from the posterior median line, and 8.82 鹵1.21 cm from the first perforating branch, and 2.23 鹵0.64 cm from the posterior median line, and the average vertical distance from the first perforating branch was 8.82 鹵1.21 cm, and from the posterior median line to 2.23 鹵0.64 cm. The average external diameter of the initial part was 2.52 鹵0.35 mm, and that of the perforating branch through the deep fascia was 0.81 鹵0.1 mm. Conclusion the perforating branch of medial sural artery is constant, carrying the source artery can obtain a long vascular pedicle, it has ideal caliber of vascular anastomosis, and it has the anatomical characteristics required for free transplantation and pedicle transfer. The clinical study of perforating branch flap of medial sural artery Objective to investigate the feasibility and clinical effect of medial sural artery perforator flap in repairing skin and soft tissue defect of extremities. Methods from June 2008 to October 2009, 10 patients with small and medium area skin and soft tissue defects of extremities were treated and repaired with medial sural artery perforator flap. Free graft was performed in 8 cases, flap area was 5cm 脳 4cm~16cm 脳 8 cm, pedicle transfer was performed in 2 cases, and flap area was 7cm 脳 5cm~10cm 脳 6 cm. After 3 months, 6 months, 9 months and 12 months of follow-up, the shape, blood supply, stability, sensory recovery, appearance and motor function of the donor area were observed. Results among the 10 cases, 9 cases survived successfully and 1 case had venous crisis under the flap. The crisis was relieved after removing and drainage, and the flap survived. The wounds of the recipient and donor areas of the flap were healed at the first stage. Follow-up for 3 to 12 months (mean 8 months) showed that 9 cases were not bloated, the skin flap was normal in color, soft in texture, no ulcers occurred, and the sensation recovered to the linear scar of the flap donor area in 3 cases, and the skin graft scar was left in 3 cases. Physical activity has no effect. Conclusion the flap of perforating branch of medial sural artery is thin and soft, the shape of the recipient area of the flap is beautiful, the injury of donor area is small, the free transplantation is suitable for repairing the soft tissue defect of middle and small area skin of limbs. Pedicle transfer can be used to repair soft tissue defect of small and medium area of knee and upper lower leg.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R322;R654.4

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