彩色多普勒超声在轴型皮瓣设计中的临床应用

Clinical application of color Doppler ultrasound in flap design

目的探讨彩色多普勒超声(CDUS)在指导临床皮瓣设计中的应用价值。方法采用CDUS对24例原位或游离皮瓣供血动脉及其穿支血管进行探查,重点探查供血动脉及穿支血管的管径、走行与分布以及穿支血管的穿出点,并在体表进行定位,以指导临床进行皮瓣设计。结果 24例皮瓣均属于轴型皮瓣,其中10例皮瓣轴心供血动脉和14例穿支皮瓣的穿支血管在CDUS图像上显示清晰,另外1例因接受过手术治疗使供血动脉遭破坏。轴心动脉的走行和穿支动脉穿出点均在体表标记,结合临床要求指导皮瓣设计,其中24例设计成功,供血动脉与术中所见符合率100%,移植后均成活。结论 CDUS可清晰显示皮瓣的供血动脉及穿支血管,并能在体表准确定位,可于术前指导皮瓣的设计,提高皮瓣移植的成活率。

Objective To evaluate clinical application of color Doppler ultrasound（CDUS）in flap design.Methods Feeding arteries and perforating branches of 24 orthotopic or free flaps were detected with CDUS.The caliber,course,distribution and perforating marking of the feeding arteries and perforating branches were detected as the key points.The course and distribution was marked on the surface of the body to direct the flap design.Results All of 24 flaps belonged to axial pattern flaps.Feeding arteries of 10 flaps and perforating arteries of 14 flaps were displayed clearly with CDUS.Feeding arteries of 1 flap were destroyed by operation before ultrasound scan.The courses of feeding arteries and perforating markings of perforator flaps were marked on the skin to direct the flap design along with requests of clinical work.Twenty-four flaps were designed successfully before transplantation and survived after operation.The coincidence of CDUS and operation was 100%.Conclusion Feeding arteries and perforating branches of flaps can be displayed clearly with CDUS and marked accurately before operation.It is helpful to raise the survival rate of the transplantation and has high clinical application value.