股前外侧穿支皮瓣的解剖学研究及其在头颈修复中的意义

Anatomic Study of Anterolateral Thigh Perforators Flap and Its Clinical Significance in Reconstruction of Head and Neck Defects

目的探讨股前外侧穿支皮瓣的解剖学基础及其在头颈修复中的临床意义。方法解剖5具新鲜成年国人尸体,观察和测量股前外侧穿支皮瓣供血穿支的数目、类型、管径、蒂长、走行、出筋膜后轴向及源血管外径,并对其进行定位。结果本组10侧标本中,共有44支股前外侧皮瓣穿支,平均每侧(4.4±1.8)支;其中,肌皮穿支30支(68.2%),肌间隔穿支14支(31.8%)。最粗穿支蒂长平均为(10.86±1.18)cm(8.29～14.44 cm),距髂前上棘与膑骨外上端中点平均距离为(3.25±0.69)cm,主要位于该点外上部。源动脉主要为旋股外侧动脉降支。蒂动、静脉外径平均为(3.16±0.59)、(3.08±0.20)mm。结论股前外侧穿支皮瓣穿支血管解剖位置较为恒定,穿支皮瓣制作方便,其管径及蒂长均适宜头颈肿瘤术后缺损的修复。

Objective To study the anatomy of the anterolateral thigh perforators flap and explore its clinical application in the reconstruction of head and neck defects.Methods Five adult fresh cadavers were prepared,and morphosis and blood supply of anterolateral thigh flap perforators were examined by microsurgery anatomy.During dissections,the following parameters were recorded:number and type of perforators vessels, diameter of perforators,pedicle length,diameter of the original vessels,route(infra fascia and sup...