侧胸腹部联合皮瓣内血管的显微外科解剖

THE VASCULAR MICROSURGICAL AMATOMY OF THE LATERL THORACICABDOMINAL SKIN FLAP

在34个侧胸腹联合皮瓣内观察测计了它们的血管。1.根据血管的走行,分支分布范围,每个皮瓣都可以第7肋为界分为上、下两部分。2.上部皮瓣内的皮动脉主要来自腋动脉的分支和肱动脉,它们都呈纵向走行,平均每个皮瓣内有这样的皮动脉3条,其中以胸外侧皮动脉、胸背皮动脉和肩胛下皮动脉的出现率最高。3.下部皮瓣内的皮动脉来自第7~12肋间动脉外侧皮支,其走向与肋间隙相一致,每个肋间隙均有相应的皮动脉出现。4.上、下部皮瓣内皮动脉各发出分支互相吻合成网,构成遍布于整个皮瓣内的动脉网。5.皮静脉基本上与皮动脉伴行,它们的外径与长度均大于相应的皮动脉。皮瓣上部的皮静脉特别是注入胸外侧皮静脉的胸腹壁静脉可延伸到下部皮瓣内。6.皮瓣内的皮静脉也都有分支互相吻合成网,构成遍布于整个皮瓣的静脉网。

The origin.external-caliber.length,course.branches and anastomosis of the cutaneous arteries(CA)of the lateral thoracic-abdominal skin flaps were studied in 34 cases(sides).The chief resulfs are as follows:(1)By seventh rib every skin flap may be divided into two parts:the upper part and lower part.(2)CA within the upper part of skin flap devive from the branches of axillary artery and brachial artry.Their Course are all longitudinal.The number of CA in every skin flap averages 3.Lateral thoracic CA.thoracodorsal CA and subscapula(?)CA.predominate.(3)CA within the lower part of skin flap derive from 7-12th lateral cutaneous branches of intercostal artery.Their course correspond with the intercostal space.(4)CA within the skin flap of upper and lowev part send out branches and form an arterial network which spreads all sver the whole skin flap.(5)External-calibers and lengths of accompanied weins are larger than the corresponding CA.The veins within the upper part of skin flap.especial the thoraco-epigastric vein which drainges blood into the lateral thoracic cutaneous veins may extend to the lower part of skin flap.(6)The cutaneous veins within the skin flap form an veins network which spreads all over the whole skin flap also.