彩色多普勒血流显像对尺动脉穿支血管的研究

Study of ulnar artery cutaneous perforators with color Doppler flow imaging

目的 利用高分辨力彩色多普勒血流显像（CDFI）研究前臂内侧尺动脉穿支血管的走行分布规律、体表的定位及血流动力学特点,为前臂内侧尺动脉穿支皮瓣设计提供依据.方法 对80例健康志愿者双侧尺动脉穿支血管（管径≥0.5 mm）数目、管径、起点位置、走行位置、穿深筋膜位置、峰值流速进行检测并行统计学分析.结果 160侧尺动脉共检测到穿支动脉345支,平均2.15支（1～3支）,可分为三种类型：Ⅰ型,肌皮穿支（10.3％）；Ⅱ型,肌间隙皮穿支（87％）；Ⅲ型,直接皮穿支（2.7％）.最粗大穿支分布于前臂内侧上1/3近段、中1/3近段和远段、下1/3近段,峰值流速左右侧及各年龄组间差异无统计学意义（P＞0.05）,男性高于女性（P＜0.05）.频谱示舒张期血流速度极低近消失,呈低速高阻单向频谱.结论 CDFI技术可直观地显示前臂内侧尺动脉穿支血管走行分布,进行体表定位,并可评价血管质量,对前臂内侧尺动脉穿支皮瓣的设计提供依据.

Objective To study the distribution,location and hemodynamics of perforating branches of the ulnar artery with color Doppler flow imaging （CDFI）.Methods Perforating branches of ulnar arteries were examined in 80 healthy volunteers in both forearms using CDFI.Following parameters were detected：number,diameter,jumping-off point,course,location and peak blood velocity.All the parameters data were analyzed statistically.Results Three hundred and forty-five perforating branches were detected in total 160ulnar arteries.These branches were classified into three types：type Ⅰ,myocutaneous perforator （10.3 %）;type Ⅱ,septocutaneous perforator（87 % ） ; type Ⅲ,direct cutaneous perforator （2.7 % ）.The most dominant branches were located in the mesial of the upper third,middle third and lower third of the forearm.There was no significant difference among all age groups and no difference in peak blood velocity between left side and right side（ P 〉0.05）.The peak blood velocity was higher in male than that in female.（ P 〈0.05）.In relaxing period,the blood flow rate was almost disappeared and the frequency spectrum showed the characteristics of single direction,lower blood velocity and higher blood resistance.Conclusions CDFI with high resolution showed better results of distribution and location of perforating branches of the ulnar artery and a better quality evaluation of the these branches.CDFI was helpful to design the skin flap containing cutaneous perforators of ulnar artery.