腹股沟区皮瓣的血管——四、血管的整体构筑

THE VESSELS OF THE SKIN FLAPS AT GROIN REGION Ⅳ.THE SUPERFICIAL VASCULAR ARCHITECTURE AS A WHOLE

本文对50例成人尸体腹股沟区浅血管进行观察并综合分析。浅动脉的组合可分成四型,腹壁浅动脉向外偏移与旋髂浅动脉合干者为主型(Ⅱ型,占64%)。浅动脉在股动脉壁上的起源有由上而下,由外而前而内依次出现旋髂浅动脉、旋髂腹壁浅动脉干、腹壁浅动脉、腹壁阴部浅动脉干和阴部外浅动脉的位置规律。寻找动脉根时可以参考此规律。合干浅动脉的管径大于不合干的相应动脉。独立起源的各支浅动脉中,以旋髂腹壁浅动脉干的出现率最高,管径较粗,分布最广,也较恒定。浅组浅静脉以旋髂浅、腹壁浅、阴部外浅等静脉分别直接回流入大隐静脉为主型(占48%)。浅组浅静脉的管径比相应浅动脉的管径为粗。根据本文观察结果,为采取腹股沟区带蒂游离皮瓣提出了一些设想。

The superficial vessels of fifty groin regions of cadavers were studied and analysed.The conformation of superficial arteries may be divided into four types.TypeⅡ(64%)is the main type,in which the superficial epigastric artery shifts laterally to combine with the superficial circumflex artery.There are five variants of the superficial arterial trunks,their origins on the wall of femoral artery are arranged from above downward and from lateral mediad in turn as follows:the superficial circumflex iliac,the superficial circumflex iliaco-epigastric,the superficial epigastric,the superficial epigastrico-pudendal and superficial external pudendal arteries.This rule may be helpful in finding out any root of the superficial arterial trunks.The caliber of a common trunk of combined arteries is larger than either one of the corresponding independent arteries.The presence of the superficial circumflex iliacoepigastric arterial trunk is in highest percentage among all superficial arterial trunks,its caliber is one of the larger ones and it supplies a constant larger area on groin skin.There are many patterns for the confluence of the superficial group of the superficial veins at groin region,in which the main pattern(48%)is represented by that the superficial circumflex iliac,superficial epigastric,and superficial external pudendal veins end into the great saphenous venous system seperately.The calibers of the superficial group veins are greater than their corresponding arteries.Based on our observations,suggestions were made for transferring free groin pedicled skin flaps.