摘要
目的探讨腓肠肌血管作为受区血管供养游离皮瓣的临床应用价值。方法2005年6月至2011年7月，观察20侧成人下肢标本腓肠肌血管的起始、走行、分支、吻合情况，测量其外径和血管蒂长度，进行手术模拟。通过16侧新鲜成人下肢标本CT影像资料观察一侧血管结扎后对腓肠肌血供影响。以腓肠肌血管供血的小腿严重创伤游离皮瓣移植52例，其中男47例，女5例。年龄23～47岁，平均27岁。结果腓肠肌主要由腓肠内、外侧血管保证血供。腓肠内侧、外侧动脉由胭动脉发出后在腓肠肌深面入肌。腓肠内侧动脉血管蒂长度为8．0～13．8cm，平均11．1em，动脉外径在入肌处为（1．8±0．3）mm。腓肠外侧动脉血管蒂长度为5．4～12．3am，平均8．8cm。腓肠内、外侧动脉的伴行静脉均为2支，人肌点处外径（2．0±0．4）mm。结扎一侧腓肠动脉后，该侧腓肠肌可以通过交通支获得足够的血液供应。52例游离组织瓣移植全部成活。随访1～2年，患肢创面愈合好，无感染复发，膝关节屈伸活动未受影响。结论腓肠肌内、外侧血管蒂长，口径较粗，作为伤肢受区血管用于游离皮瓣移植。对伤肢血供影响小，临床应用可靠，大大简化了手术。
Objective To evaluate clinical application of the gastrocuemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011, twenty adult lower limbs were infused with red glue to observe the origin, streching, branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further. CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 - 13.8 cm in length which averaged 11.1 cm and their outer diameters were （1.8± 0.3） mm when they en- tered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm. The outer diameters of the two accompanying veins were （1.8±0.3）mm when they entered the muscles. When one gastrocnemius blood vessle were obstructed, the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles. All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees＇ motions were normal. Conclusions With a long pedicle and wide diameter, the medial or lat- eral gastrocnemius blood vessle can be a reliable alternative used in free flap transplantation for repairing large defects of skin and soft tissue
出处
《中华显微外科杂志》
CSCD
北大核心
2012年第3期183-185,I0007,共4页
Chinese Journal of Microsurgery
基金
全军“十一五”面上科研项目（06MB126）
关键词
腓肠肌血管
小腿
游离皮瓣
创伤
移植
Gastrocnemius blood vessle
Leg
Free flap
Trauma
Transplantation
