臂内侧中下段皮肤穿支动脉的解剖学观察

Anatomy observation of the perforating artery in lower medial arm skin

目的观察臂内侧中下段皮肤动脉的解剖学特点,为制作吻合臂内侧穿支动脉的微型皮瓣提供解剖学基础。方法3侧经动脉灌注红色乳胶的成年上臂新鲜标本,以臂内侧中下段深筋膜为基点,观察臂内侧中下段皮肤的穿支血管数量及每一穿支的外径、供血范围及各穿支之间的位置关系。结果臂内侧中下段皮肤动脉通常出现3个较大的皮肤穿支,标本1的3支完全来自肱动脉直接穿支,标本2的3支完全来自尺侧下副动脉穿支,标本3的3支中来自肱动脉穿支1支与尺侧下副动脉皮支2支,其中肱动脉的直接穿支为主。结论臂内侧中下段皮肤穿支动脉变异较大,距肱骨内上髁约80 mm左、右、上、下10 mm可找到一根较粗皮肤穿支动脉。建议在切取吻合臂内侧穿支动脉的微型皮瓣时应注意须先在距肱骨内上髁约80 mm左右作一纵形切口,先切开一侧,找到其中一支较大皮肤穿支动脉,再以该穿支血管为中心设计皮瓣。

Objective To observe the inside of the lower arm arterial anatomy of skin and provide anatomical basis for microsurgery for the production of consistent perforating artery of the medial arm flap.Methods 3 sides of adult specimens of the upper arm by arterial infusion of fresh red latex was observed through the inside of the lower arm anchored to the deep fascia,observed the number of each vessel a diameter of perforating branches,perforating branches of the blood supply range and the relationship between the position in the antegrade dissection of the inside of the lower arm the skin.Results Usually there were three large arteries of the skin through branches in the lower medial arm skin.One of three specimens was a complete direct perforating branches from the brachial artery;Three of 2nd specimens entirely come from the ulnar vice artery;One of three in 3rd three specimens support come from the brachial artery and 2 come from the deputy ulnar cutaneous branch,in which the brachial artery directly through the main branch.Conclusion It is varied greatly in section of skin under the arm medial perforating artery.It can be found a perforating artery in about 10mm thick skin from the medial epicondyle of about 80mm.It recommended that should pay attention to away from the medial epicondyle of about 80mm or so to make a longitudinal incision,the first cut on one side,which found a large perforating artery skin when cuting consistent with perforating artery of the medial arm flap,and design the flap around the center of the vessel.