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目的为腹壁下动脉穿支皮瓣的设计与安全截取提供解剖学依据。方法 8具新鲜尸体,采用选择性颜料灌注、动脉造影及CT扫描与三维重建,重点观察腹壁下动脉肌皮穿支及其跨越正中线的有效吻合血管。然后,层次解剖观测腹前外侧壁外径≥0.5 mm的穿支,测量其管径及其走行、分支、分布情况并拍摄X线片。利用Photoshop与Scion Image软件分析穿支供血的趋向性及其供血面积。结果腹壁下动脉的出现率为100%,平均每侧发出(4.8±1.7)支肌皮穿支,直径(0.7±0.2)mm,单穿支供血面积为33cm2,单个穿支皮瓣大小为20cm×15cm。结论腹壁下动脉起源、行程及其穿支较恒定。双侧肌皮穿支间有丰富的、跨越正中线的真性吻合,具备截取跨越中线的横向跨区穿支皮瓣的解剖学基础,横向皮瓣面积可达20cm×42cm。
Objective To provide an anatomical basis for the design and safety interception of the inferior epigastric artery perforator flap. Method 8 Fresh corpses, selective pigment perfusion, arteriography and CT scan and three-dimensional reconstruction, focusing on the observation of periapical artery myocutaneous perforating branches and effective anastomosis vessels across the midline. Then, the level of anatomical observation of the anterolateral abdominal wall diameter ≥ 0.5 mm perforation, measuring its diameter and its walking, branching, distribution and X-ray film. Using Photoshop and Scion Image software to analyze the trend of perfused blood supply and its blood supply area. Results The incidence of the inferior abdominal artery was 100%. The average diameter of peroneal sheath perforation was (4.8 ± 1.7) mm and diameter was (0.7 ± 0.2) mm. The diameter of the perforator was 33cm2. The size of the perforator flap was 20cm × 15cm. Conclusion The origin, stroke and perforating branch of inferior abdominal artery are more constant. The bilateral musculocutaneous bifurcation is rich in anastomosis across the midline and possesses the anatomical basis for transecting the transverse cross-sectional perforator flap across the midline with a lateral flap area of up to 20 cm × 42 cm.