彩色多普勒超声对股前外侧皮瓣穿支的研究

A study of anterolateral thigh flap cutaneous perforators with Color Doppler Flow Imaging

目的:利用高分辨力彩色多普勒血流成像技术(CDFI)研究股前外侧皮瓣(anterolateral thigh flap,ALTF)穿支血管的分布规律、体表的定位及血流动力学,为ALTF设计提供依据。方法:对120例健康志愿者双侧ALTF穿支血管的数目、管径、起点位置、走行位置、穿深筋膜位置、平均流速进行检测,并做统计学分析。结果:单侧ALTF穿支血管平均2.25支,三种类型:Ⅰ型肌皮穿支(65.9%);Ⅱ型肌间隙皮穿支(30.7%);Ⅲ型直接皮穿支(3.4%)。最粗大穿支血管(深筋膜穿出点)97.1%出现在髂前上棘至髌骨外侧缘中点连线的中1/3段。平均血流速度左右侧及各年龄组间差异无统计学意义(P>0.05),男性稍高于女性(P<0.05)。结论:CDFI技术可直观地显示ALTF穿支的走行分布、进行体表定位,并可评价血管质量,从而更好地指导术前ALTF设计,具有较好的临床应用前景。

Objective：To study the distribution,location and hemodynamic parameter of the blood vessel of anterolateral thigh flap （ALTF） with Color Doppler Flow Imaging （CDFI）. Methods：There were 120 normal volunteers＇ cutaneous perforators examined on both thighs. The number,diameter,course,location,and the mean velocity（Vmean） were recorded. All these data were analyzed statistically. Results：The average number of cutaneous perforators was 2.25. They were classified into three types： Ⅰ myocutaneous perforator （65.9%）, Ⅱ septocutaneous perforator（30.7% ）, m direct cutaneous perforator （3.4%）. 97.1% of the dominant cutaneous perforators were located in the middle third of the thigh. There were no significant difference in the Vmean between left and right dominant cutaneous perforators and source vessels. The result was alike among all age groups. Male＇s mean velocity was higher than that of female （P〈 0.05）. Conclusion：The Color Doppler ultrasound with high resolution could show the distribution and location clearly,assess the quality of the blood flow of ALTF,provid scientific basis for successful grafting and have better prospects in clinic.