股前區(qū)皮下脂肪厚度的測(cè)量及皮膚穿支血管的臨床應(yīng)用解剖研究
發(fā)布時(shí)間：2019-02-14 13:20
【摘要】： 目的 測(cè)量股前區(qū)不同部位的皮下脂肪厚度,解剖觀察其皮膚穿支血管的分布、數(shù)量、類型、來(lái)源。為臨床制備股前區(qū)單島皮瓣及一蒂多島皮瓣提供參考。 方法 選取2008年10月至2009年4月在中南大學(xué)湘雅二醫(yī)院口腔頜面外科住院,行口腔頜面部惡性腫瘤切除術(shù)并Ⅰ期行左股前區(qū)游離皮瓣修復(fù)的患者66例。將股前區(qū)分為股前外側(cè)區(qū)和股前內(nèi)側(cè)區(qū),其再分為上、中、下3個(gè)區(qū)域。1.測(cè)量股前區(qū)各區(qū)域的皮下脂肪厚度。2.制備皮瓣過(guò)程中,利用制備皮瓣的切口,在盡量不增加對(duì)患者局部損傷的前提下,解剖觀察左側(cè)股前區(qū)各區(qū)域皮穿支血管的分布、數(shù)量、類型及來(lái)源。 結(jié)果 1.股前區(qū)皮下脂肪厚度下份＜中份＜上份,左右側(cè)無(wú)明顯差異,女性股前區(qū)皮下脂肪厚度大于男性。2.股前外側(cè)區(qū)的上中下區(qū)域均有皮穿支血管分布,位于上份的占25.4%,中份的占34.7%,下份的占38.2%。中份出現(xiàn)皮穿支血管的概率(97%)＞下份(89.4%)＞上份(83.3%)。股前外側(cè)區(qū)平均有4.4±1.4支皮穿支血管,下份的穿支血管數(shù)(1.9±0.8支)多于上份(1.4±0.5支)和中份(1.6±0.6支)。來(lái)源于降支的占76.3%,橫支的占19.2%,升支的占1.4%,其它占3.1%,主要為肌皮穿支。3.股前內(nèi)側(cè)區(qū)的上中下區(qū)域均有皮穿支血管分布,位于上份的占17.1%,中份的占35.7%,下份的占46.3%。下份出現(xiàn)皮穿支血管的概率(95.5%)＞中份(84.9%)＞上份(51.5%)。皮穿支血管平均為3.3±1.1支,主要來(lái)源于股動(dòng)脈及其分支,以肌皮穿支為主。57.6%的患者(38/66)股前內(nèi)側(cè)區(qū)的中、上份區(qū)域存在來(lái)源于旋股外側(cè)動(dòng)脈降支的皮穿支血管。 結(jié)論 1.股前區(qū)上下區(qū)域皮下脂肪厚度差異明顯,下份＜中份＜上份。 2.股前區(qū)上、中、下區(qū)域均有穿支血管分布,可以根據(jù)臨床需要制備不同厚度的皮瓣。 3.旋股外側(cè)動(dòng)脈及其分支所發(fā)出的皮穿支血管分布于股前區(qū)多個(gè)區(qū)域,可以根據(jù)所需皮瓣的大小選擇不同區(qū)域的皮瓣進(jìn)行組合,制備一蒂多島皮瓣。
[Abstract]:Objective to measure the thickness of subcutaneous fat in different parts of prefemoral area and to anatomize the distribution, quantity, type and origin of perforating vessels. To provide reference for clinical preparation of single island flap of anterior femoral area and one pedicle island flap. Methods 66 patients who were hospitalized in oral and maxillofacial surgery from October 2008 to April 2009 in Xiangya second Hospital of Central South University underwent resection of malignant tumors of oral and maxillofacial region and repair of left anterior femoral free flap in the first stage. The anterior femoral area is divided into anterolateral femoral area and anterior medial femoral area, which is divided into 3 regions: upper, middle and inferior. 1. Measure the thickness of subcutaneous fat in the area of anterior femur. 2. During the preparation of the flap, the incision of the prepared flap was used to observe the distribution, quantity, type and origin of the perforating branches of the left prefemoral region without increasing the local injury to the patients. Result 1. There was no significant difference in the thickness of subcutaneous fat in the anterior femoral area between the left and the right, but the thickness of the subcutaneous fat in the anterior femoral area was greater in women than in men. There were cutaneous perforating branches in the superior middle and inferior areas of the anterolateral femoral area, which accounted for 25.4% in the superior part, 34.7 in the middle part and 38.2% in the next. The probability of cutaneous perforating vessels appeared in the middle (97%) was higher than that in the next (89.4%) > in the superior (83.3%). The average number of perforating vessels in the anterolateral femoral region was 4.4 鹵1.4, and the number of perforating vessels in the inferior part (1.9 鹵0.8) was higher than that in the superior (1.4 鹵0.5) and the middle (1.6 鹵0.6). The descending branch accounted for 76.3%, the transverse branch 19.2%, the ascending branch 1.4 and the others 3.1, mainly for the musculocutaneous perforating branch. There were cutaneous perforators in the superior middle and inferior areas of the anterior medial area of the femur, which were 17.1 in the superior, 35.7in the middle and 46.3 in the next. The probability of cutaneous perforating vessels was 95.5%, 84.9%, 51.5%, respectively. The average number of cutaneous perforator vessels was 3.3 鹵1.1, mainly from femoral artery and its branches. 57.6% (38 / 66) of patients (38 / 66) were in the anterior medial femoral area. In the superior region, there are cutaneous perforators derived from the descending branch of lateral femoral circumflex artery. Conclusion 1. The thickness of subcutaneous fat in the upper and lower areas of prefemoral area was significantly different. 2. Perforating vessels are distributed in the prefemoral, middle and inferior femoral regions, and different thickness flaps can be prepared according to the clinical needs. 3. The cutaneous perforator vessels from lateral circumflex femoral artery and its branches are distributed in multiple regions of the anterior femoral area. According to the size of the required flap, the skin flap in different regions can be combined to produce a multi-island flap with one pedicle.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R322
本文編號(hào)：2422238
[Abstract]:Objective to measure the thickness of subcutaneous fat in different parts of prefemoral area and to anatomize the distribution, quantity, type and origin of perforating vessels. To provide reference for clinical preparation of single island flap of anterior femoral area and one pedicle island flap. Methods 66 patients who were hospitalized in oral and maxillofacial surgery from October 2008 to April 2009 in Xiangya second Hospital of Central South University underwent resection of malignant tumors of oral and maxillofacial region and repair of left anterior femoral free flap in the first stage. The anterior femoral area is divided into anterolateral femoral area and anterior medial femoral area, which is divided into 3 regions: upper, middle and inferior. 1. Measure the thickness of subcutaneous fat in the area of anterior femur. 2. During the preparation of the flap, the incision of the prepared flap was used to observe the distribution, quantity, type and origin of the perforating branches of the left prefemoral region without increasing the local injury to the patients. Result 1. There was no significant difference in the thickness of subcutaneous fat in the anterior femoral area between the left and the right, but the thickness of the subcutaneous fat in the anterior femoral area was greater in women than in men. There were cutaneous perforating branches in the superior middle and inferior areas of the anterolateral femoral area, which accounted for 25.4% in the superior part, 34.7 in the middle part and 38.2% in the next. The probability of cutaneous perforating vessels appeared in the middle (97%) was higher than that in the next (89.4%) > in the superior (83.3%). The average number of perforating vessels in the anterolateral femoral region was 4.4 鹵1.4, and the number of perforating vessels in the inferior part (1.9 鹵0.8) was higher than that in the superior (1.4 鹵0.5) and the middle (1.6 鹵0.6). The descending branch accounted for 76.3%, the transverse branch 19.2%, the ascending branch 1.4 and the others 3.1, mainly for the musculocutaneous perforating branch. There were cutaneous perforators in the superior middle and inferior areas of the anterior medial area of the femur, which were 17.1 in the superior, 35.7in the middle and 46.3 in the next. The probability of cutaneous perforating vessels was 95.5%, 84.9%, 51.5%, respectively. The average number of cutaneous perforator vessels was 3.3 鹵1.1, mainly from femoral artery and its branches. 57.6% (38 / 66) of patients (38 / 66) were in the anterior medial femoral area. In the superior region, there are cutaneous perforators derived from the descending branch of lateral femoral circumflex artery. Conclusion 1. The thickness of subcutaneous fat in the upper and lower areas of prefemoral area was significantly different. 2. Perforating vessels are distributed in the prefemoral, middle and inferior femoral regions, and different thickness flaps can be prepared according to the clinical needs. 3. The cutaneous perforator vessels from lateral circumflex femoral artery and its branches are distributed in multiple regions of the anterior femoral area. According to the size of the required flap, the skin flap in different regions can be combined to produce a multi-island flap with one pedicle.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R322
【引證文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 黃江;60例游離股前外側(cè)肌皮瓣術(shù)后供區(qū)并發(fā)癥及功能評(píng)價(jià)的研究[D];中南大學(xué);2011年
，本文編號(hào)：2422238
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