缝匠肌穿支皮瓣的应用解剖学研究

Applied anatomy of the sartorius perforator flap

目的明确缝匠肌肌皮动脉穿支和肌间隙穿支的分布区域特征，为缝匠肌穿支皮瓣的临床应用提供解剖学依据。方法逐层解剖12侧经红色乳胶灌注的成人下肢新鲜标本，观察缝匠肌动脉血供特征、穿支数目及优势血管分布。结果由各动脉发出进入缝匠肌及其表面皮肤的穿支血管有7～12支，其中以缝匠肌中、上段穿支分布较为集中，主要为股动脉发出。肌皮穿支有3-4支，平均管径（1．30±0．15）mm，蒂长（1．10±0．10）cm；肌间隙穿支2～3条，管径（1．20±0．20）mm，蒂长（1．15±0．15）cm。此外，旋股外侧动脉发出一较长肌间隙穿支，管径（1．35±0．05）mm，蒂长（7．20±1．40）cm，可达缝匠肌中段。结论缝匠肌中、上段穿支较多而位置相对恒定，设计缝匠肌皮瓣游离移植修复组织缺损是切实可行的。

Objective To ascertain blood supply distribution of the sartorius perforators,including myocutaneous branches and direct cutaneous perforator, and provide anatomic basis for clinical application of sartorius perforator flap. Methods Twelve flesh unfixed corpses with red latex injection were dissected layer by layer. The distribution characteristics of dominant arteries of sartorius and the number of perforators were observed and analyzed. Results There were generally 7-12 perforating branches in sartorius muscle, from femoral artery, lateral femoral circumflex artery or descending genicular artery. The middle and inferior parts of sartorius received 3-4 myocutaneous perforators and 2-3 intermuscular space perforators originated from femoral artery, with the average external diameter of （1.7±0.6）mm, and the pedicle length of （2.8±1.2）cm. The perforators from the same origin were common. Conclusions Considering that perforating branches appeared in the lower part of sartorius muscle are abundant and constant, which is more feasible to design flap for tissue defect repair.