彩色多普勒仪检测足背动脉的临床意义

Detection of the arteries of the foot by colour Doppler flowmeter scanning and its clinical significance

目的 应用彩色多普勒仪检测足背动脉及其分支的血流 ,为改进足部移植组织的切取提供依据。方法 对正常志愿者 2 5人 5 0只足 ,检测足背动脉及其分支的行径。对 16例足趾移植再造拇手指者 ,术前采用彩色多普勒仪检测足背及第一跖背动脉的情况 ,并和术中发现作比较。结果 5 0只足足背动脉的解剖结构为 :第一跖背动脉的出现率为 92 %。第二跖背动脉的出现率为 66% ,源自足底动脉的占4 6% ,源自弓状动脉的占 2 0 %。第一趾足底总动脉的出现率为 60 % ,而第二趾足底总动脉的出现率为5 8%。 16例患者术前足背动脉血流显像与术中所见相符 ,2例为顾玉东 型 (肌下型 )、 S型 (肌下、小支型 ) ,1例为 型 (缺如型 )。 13例分别为 型 (浅表型 )或 型 (肌内型 )。结论 彩色多普勒对血管的检测结果是可靠的、有效的。术前根据足背动脉及其分支的情况 ,可改进单足供趾再造手的操作技术 。

Objective To detect the anatomical location of the arteries of the foot by colour Doppler, and explore the possibility of improving the present technique of harvesting toes from one foot in toe to hand transfer. Methods Preoperative colour Doppler flowmeter scanning was performed in 16 patients with toe to hand transfer to detect the dorsalis pedis artery and the first dorsal metatarsal artery. The results were compared with the intraoperative findings to establish the method for detecting the arteries of the foot by colour Doppler, which was then used to examine 50 feet of 25 volunteers. Results The anatomical structure of the vascularity in 50 feet revealed that the first dorsal metatarsal artery was present in 92 % of the series, and the second dorsal metatarsal artery in 66 %. The blood supply of the toe derived from the plantar pedal artery in 46 % and from the dorsal pedal arterial arch in 20 % of the series. The presence of the first and second plantar metatarsal artery was 60 % and 58 % respectively. The anatomical structure of the arteries of the foot detected by preoperative colour Doppler examination was in accordance with the intraoperative findings in the 16 patients of toe to hand transfer. 2 cases were categorized as Gu's type Ⅲ S (inframuscular, small diameter), 1 case as type Ⅳ(absent), and 13 cases as type I(superficial) or Type Ⅱ(intramuscular). Conclusions Detection of the arterial structure of the foot by colour Doppler is practicable and reproducible with reliable results. It can provide information of the location and the course of the arteries, which is helpful to improve the technique of harvesting the toe in toe to hand transfer and improve the functional restoration.