小腿皮瓣筋膜血管的解剖学

Anatomy of fascial vessels of skin flap in leg

目的：系统并定量研究小腿皮瓣筋膜的血管，探讨筋膜皮瓣成活机制，并为临床应用提供形态学基础。方法：对１３例成人标本进行了巨微解剖、组织透明、切片观察和图像分析。结果：小腿筋膜有４种动脉来源，而以肌间隔皮动脉为主。各种动脉在深筋膜的分支均显示浅支多而粗；深筋膜血管网也以浅血管网较密。深筋膜血管面积百分比（Ａａ％）值大于浅筋膜。结论：深筋膜血管特别是深筋膜浅血管网是小腿筋膜皮瓣的血供基础，筋膜蒂宜放在动脉链状吻合处。

Objective: The fascial vessels of skin flap in leg were studied systematically and quantitatively to seek the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application.Methods: Thirteen legs from adult cadavers were observed and measured by dissection under operating and biological microscopies, tissue clearing,slides and image analysis. Results: There were four types of source arteries in fascia of leg among which the intermuscular septal cutaneous artery was predominant and often anastomosed as chains. The source arteries had supra and subfascial branches in deep fascia and the former was more and larger. In the same way, the vascular network was thicker in the suprafascial level than in the subfascial level. Aa% of the deep fascia was larger than that of the superficial fascia. Conclusion: The deep fascial vascular networks are the basis of the blood supply of the fasciocutaneous flap in leg among which the suprafascial vascular network is especially important. It is suggested that the fascial pedicle be located where arterial chain exists.