腓动脉主穿支彩超定位对穿支腓肠神经营养血管皮瓣的临床意义(1)
摘要：目的 研究腓動脉主穿支彩超定位对穿支腓肠神经营养血管皮瓣的临床意义。方法 回顾分析2018年1月～2019年1月在我院行穿支腓肠神经营养血管皮瓣术治疗的45例患者临床资料和同期20例健康体检者资料。45例患者术前采用腓动脉主穿支彩超定位，对比术前与术中结果，总结检查技巧。结果 每侧小腿平均由腓动脉主穿支4.1支，主要分布于腓骨头至外踝间连线第2～9段，外径(0.81～1.91)mm，平均外径(1.14±0.23)mm;最粗1支外径(1.01～1.90)mm，平均外径(1.44±0.29)mm，其中80.00%分布于第3～5段;主穿支及最大穿支在小腿中1/3的出现几率最多;术前采用彩色多普勒血流成像技术(CDFI)确定45条目标穿支，术中确认39条，假阳性3条，假阴性3条，灵敏度92.85%;45块皮瓣均成活，术后均未观察到缺血或淤血。结论 依据腓动脉穿支分布规律，设计不同切取节段主穿支蒂腓肠神经营养血管皮瓣，可以满足除前足外不同平面小腿及踝部创面修复需求。同时了解最大腓动脉穿支情况，可采用游离移植解决，CDFI可满足穿支腓肠神经营养血管皮瓣术前定位的要求。
关键词：腓动脉;彩超;穿支腓肠神经;皮瓣
中图分类号：R658.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.13.052
文章编号：1006-1959(2019)13-0162-02
Abstract：Objective To study the clinical significance of the main perforating color of the radial artery in the percutaneous neuromuscular flap. Methods Retrospectively analyzed the clinical data of 45 patients who underwent percutaneous transluminal neurovascular flap in our hospital from January 2018 to January 2019， and the data of 20 healthy subjects in the same period. Forty-five patients underwent preoperative high-frequency positioning of the radial artery， comparing preoperative and intraoperative results， and summarizing the examination techniques. Results The average calf of each side was 4.1 branches of the radial artery. It was mainly distributed in the 2nd to 9th segments of the humeral head to the external iliac crest. The outer diameter was (0.81-1.91)mm and the average outer diameter was (1.14±0.23)mm. The outer diameter of the outer diameter is (1.01～1.90)mm， and the average outer diameter is (1.44±0.29)mm， 80.0% of which is distributed in the 3rd to 5th segments. The main perforating branch and the maximum perforating branch have the highest probability of 1/3 in the lower leg. Preoperative color Doppler flow imaging (CDFI) was used to determine 45 target perforators， 39 were confirmed during operation， 3 were false positives， 3 were false negatives， and the sensitivity was 92.85%. All 45 flaps survived. No ischemia or congestion was observed afterwards. Conclusion According to the distribution rule of the perforating branch of the radial artery， the main perforating pedicled sural neurotrophic vascular flap can be designed to meet the needs of different lateral calf and ankle wounds except for the forefoot. At the same time， to understand the maximum brachial artery perforation， free transplantation can be used to solve the problem. CDFI can meet the requirements of preoperative positioning of the perforating and sural neurovascular flap., 百拇医药(张微 崔玉莹)
关键词：腓动脉;彩超;穿支腓肠神经;皮瓣
中图分类号：R658.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.13.052
文章编号：1006-1959(2019)13-0162-02
Abstract：Objective To study the clinical significance of the main perforating color of the radial artery in the percutaneous neuromuscular flap. Methods Retrospectively analyzed the clinical data of 45 patients who underwent percutaneous transluminal neurovascular flap in our hospital from January 2018 to January 2019， and the data of 20 healthy subjects in the same period. Forty-five patients underwent preoperative high-frequency positioning of the radial artery， comparing preoperative and intraoperative results， and summarizing the examination techniques. Results The average calf of each side was 4.1 branches of the radial artery. It was mainly distributed in the 2nd to 9th segments of the humeral head to the external iliac crest. The outer diameter was (0.81-1.91)mm and the average outer diameter was (1.14±0.23)mm. The outer diameter of the outer diameter is (1.01～1.90)mm， and the average outer diameter is (1.44±0.29)mm， 80.0% of which is distributed in the 3rd to 5th segments. The main perforating branch and the maximum perforating branch have the highest probability of 1/3 in the lower leg. Preoperative color Doppler flow imaging (CDFI) was used to determine 45 target perforators， 39 were confirmed during operation， 3 were false positives， 3 were false negatives， and the sensitivity was 92.85%. All 45 flaps survived. No ischemia or congestion was observed afterwards. Conclusion According to the distribution rule of the perforating branch of the radial artery， the main perforating pedicled sural neurotrophic vascular flap can be designed to meet the needs of different lateral calf and ankle wounds except for the forefoot. At the same time， to understand the maximum brachial artery perforation， free transplantation can be used to solve the problem. CDFI can meet the requirements of preoperative positioning of the perforating and sural neurovascular flap., 百拇医药(张微 崔玉莹)