本文選題：帶蒂穿支皮瓣 + 血流動(dòng)力學(xué)��； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：應(yīng)用高頻超聲測(cè)定穿支動(dòng)脈淺出點(diǎn)位置和監(jiān)測(cè)術(shù)前、術(shù)后穿支血管血流動(dòng)力學(xué)和管徑大小變化,并觀察其與皮瓣存活的關(guān)系,為其臨床應(yīng)用提供可靠的科學(xué)依據(jù),從而有利于提高帶蒂穿支皮瓣在臨床中修復(fù)創(chuàng)面的療效。方法：選取2014年4月至2015年2月我科行帶蒂穿支皮瓣轉(zhuǎn)位修復(fù)四肢軟組織缺損患者31例,采用GE LOGIQ E9型超聲多普勒診斷儀對(duì)術(shù)前穿支血管淺出點(diǎn)進(jìn)行定位并與術(shù)中所見(jiàn)相對(duì)比,檢測(cè)術(shù)前、術(shù)后1、2、3、5、7、14天帶蒂穿支皮瓣中穿支動(dòng)脈血流動(dòng)力學(xué)參數(shù)及管徑變化并計(jì)算其血流量大小,觀察記錄皮瓣大體的存活情況,分析皮瓣存活相關(guān)影響因素。所有臨床資料均應(yīng)用SPSS for Windows 16.0統(tǒng)計(jì)軟件進(jìn)行分析與處理,并以a=0.05作為其檢驗(yàn)水準(zhǔn)。結(jié)果：(1)術(shù)后穿支皮瓣穿支動(dòng)脈流量較術(shù)前增高,術(shù)后1-5天時(shí)呈逐漸上升,峰值出現(xiàn)在第5天,然后呈逐漸下降趨勢(shì),至術(shù)后14天仍高于術(shù)前。(2)術(shù)前穿支動(dòng)脈流量大小與旋轉(zhuǎn)點(diǎn)至皮瓣存活最遠(yuǎn)端長(zhǎng)度呈正相關(guān)(r=0.987,P=0.000)。(3)高頻超聲術(shù)前對(duì)穿支血管淺出點(diǎn)定位與術(shù)中所見(jiàn)位置完全符合。傳統(tǒng)體表定位的皮瓣軸線與皮瓣穿支動(dòng)脈血管鏈軸線有角度偏差,偏差成角約為4.70～8.5°(平均6.5°)。結(jié)論：(1)穿支動(dòng)脈術(shù)前流量大小與術(shù)后皮瓣存活面積呈正相關(guān),其流量大小的變化與皮瓣的病理生理變化相符,對(duì)判斷皮瓣預(yù)后具有一定指導(dǎo)作用。(2)高頻超聲是測(cè)定穿支動(dòng)脈淺出點(diǎn)和血管鏈軸線準(zhǔn)確、有效的方法。
[Abstract]:Objective: to determine the location of perforator artery point and monitor the changes of blood flow dynamics and diameter of perforator vessels after operation by high frequency ultrasound, and observe the relationship with the survival of the skin flap, provide a reliable scientific basis for its clinical application, and thus help to improve the curative effect of the pedicled perforator flap in the clinical repair of the wound. From April 2014 to February 2015, we took the pedicle perforator flap to repair 31 cases of soft tissue defect in the extremities. The GE LOGIQ E9 ultrasonic Doppler diagnostic instrument was used to locate the superficial point of the perforator vessels before the operation and compared with those in the operation. The hemodynamic parameters of the perforator perforator flap in the pedicle perforator flap were detected before the operation. SPSS for Windows 16 statistical software was used to analyze and deal with the survival of skin flaps. All clinical data were analyzed and processed with a=0.05 Windows 16 software, and the results were as follows: (1) the flow of perforator perforator artery was increased after operation. High, 1-5 days after the operation gradually increased, the peak appeared at fifth days, and then declined gradually, to 14 days after the operation is still higher than before the operation. (2) the size of the perforating artery before the operation is positively correlated with the rotation point to the distal length of the flap survival (r=0.987, P=0.000). (3) the location of the perforating vessels and the position in the operation before Gao Pinchao sound operation is complete. There was an angle deviation between the axis of the skin flap and the axis of the vascular chain of the perforator artery of the traditional body surface, and the deviation angle was about 4.70 to 8.5 degrees (average 6.5 degrees). Conclusion: (1) the size of the perforating artery was positively correlated with the survival area of the flap after operation, and the change of the flow size was consistent with the pathophysiological changes of the flap. (2) high frequency ultrasound is an accurate and effective method for determining the superficial point of perforating artery and the axis of vascular chain.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R622

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