摘要
目的分析CT血管造影数字化三维重建技术设计股前外侧穿支皮瓣在下肢大面积软组织缺损患者中的应用效果。方法将80例下肢大面积软组织缺损患者分为观察组和对照组,各40例。观察组术前采用CT血管造影数字化三维重建技术进行皮瓣设计并指导手术操作,对照组术中采用多普勒超声辅助设计皮瓣后进行皮瓣移植。比较观察组穿支血管的术前CT血管造影数字化三维重建技术测量结果与术中实际测量值。比较两组患者术后4周的皮瓣成活率、皮瓣并发症发生率、供区并发症发生率及移植皮瓣区的感觉功能。结果观察组术前CT血管造影数字化三维重建技术测量的穿支起始点直径、穿支起始点至髌骨上缘直线距离、穿支起始点至大腿外侧缘直线距离与术中实际测量值的差异均无统计学意义(均P>0.05)。术后4周,观察组患者皮瓣并发症发生率低于对照组,移植皮瓣区的感觉功能优于对照组(均P<0.05),而两组患者的皮瓣成活率和供区并发症发生率差异均无统计学意义(均P>0.05)。结论术前采用CT血管造影数字化三维重建技术可以准确了解旋股外侧动脉分支及穿支血管的解剖学特点,以此设计穿支皮瓣进行逆行股前外侧穿支皮瓣移植可维持皮瓣良好血运,降低术后皮瓣并发症发生率,利于移植皮瓣区感觉功能的恢复。
Objective To analyze the application effect of anterolateral thigh perforator flap designed by CT angiography digital three-dimensional reconstruction technique in patients with large-area soft tissue defect of lower extremity.Methods A total of 80 patients with large-area soft tissue defect of lower extremity were assigned to observation group or control group,with 40 cases in each group.The observation group employed preoperative CT angiography digital three-dimensional reconstruction technique to design flap and to guide the operation,and the control group used intraoperative Doppler ultrasound to achieve adjuvant design of flap,and then to perform flap transplantation.The measured result of preoperative CT angiography digital three-dimensional reconstruction technique of perforator vessel versus intraoperative practical measured value in the observation group was compared.The 4-week postoperative flap survival rate,incidence rates of complications in flap and donor area,and sensory function in transplanted flap area of patients were compared between the two groups.Results Starting point diameter of perforator,straight-line distance from starting point of perforator to superior margin of patella,and straight-line distance from starting point of perforator to lateral margin of thigh measured by preoperative CT angiography digital three-dimensional reconstruction technique presented no statistically significant difference with intraoperative practical measured value in the observation group(all P>0.05).After 4 weeks of operation,patients in the observation group obtained a lower incidence rate of flap complications,and a superior sensory function in transplanted flap area as compared with the control group(all P<0.05),whereas there was no statistically significant difference in the flap survival rate and incidence rate of complications in donor area of patients between the two groups(all P>0.05).Conclusion Employing CT angiography digital three-dimensional reconstruction technique before operation can accurately
作者
何雨生
刘俊
陈耀武
郭双飞
赵鑫
刘小仁
李承杰
王新平
HE Yusheng;LIU Jun;CHEN Yaowu;GUO Shuangfei;ZHAO Xin;LIU Xiaoren;LI Chengjie;WANG Xinping(Department of Extremity,Hand and Foot Microsurgery,the First People′s Hospital of Chenzhou,Chenzhou 423000,Hunan,China)
出处
《广西医学》
CAS
2023年第5期511-515,共5页
Guangxi Medical Journal
基金
湖南省郴州市科学技术局科技发展计划项目(ZDYF2020093)
郴州市第一人民医院院级科研项目(N2020-54)。
关键词
下肢大面积软组织缺损
穿支皮瓣
逆行股前外侧穿支皮瓣移植
CT血管造影
数字化三维重建
Large-area soft tissue defect of low extremity
Perforator flap
Retrograde anterolateral thigh perforator flap transplantation
CT angiography
Digital three-dimensional reconstruction
