超声检查在腓骨肌(皮)瓣修复下颌骨缺损中的作用

DOPPLER PROBING IN FREE FIBULA FLAP RECONSTRUCTION OF MANDIBULAR DEFECTS

目的 研究超声检测技术在腓骨肌 (皮 )瓣修复下颌骨缺损过程中的作用。方法 9例腓骨肌 (皮 )瓣修复下颌骨缺损的病例 ,术前彩超检查以确定腓动脉是否单独存在 ,带皮瓣修复者 ,将腓动脉皮支体表定位。单纯腓骨瓣转移者 ,术后超声多普勒听诊仪检测移植瓣动脉的血流情况。结果 9例腓动脉均单独存在 ,术后腓骨瓣及所带皮瓣全部存活。彩超检查确定腓动脉皮支的位置及数量 ,便于所带皮瓣的术前设计和术中操作 ;超声多普勒听诊检查结果准确地反映了移植瓣动脉的血流状态。结论 超声检查在腓骨肌 (皮 )瓣修复下颌骨缺损术前观察腓血管的结构 。

Objective To evaluate the role of doppler probing in free fibula flap reconstruction of mandibular defects. Methods Nine cases with mandibular defect were reconstructed with free fibula flap. Preoperatively, color doppler was used to identify whether absence of peroneal artery or not, the cases with skin flap attached, the distribution of cutaneous branches from peroneal artery were located and marked on the skin. After operation, stethoscope doppler was used to monitor blood flow within artery of transplant. Results All the cases peroneal artery were presence and vascularized flaps of fibula and skin survived with success rate of 100%. Color doppler was used to identify the number and location of cutaneous branches from peroneal artery preoperatively, then it's easy to design and manipulate the skin flap attached to free fibula flap. The readings of stethoscope doppler reflect blood flow within artery of transplant precisely. Conclusion Doppler probing is important to free fibular flap reconstruction of mandible defect. It was useful to identify the peroneal artery and the cutaneous branches preoperatively, and to monitor blood supply of the transplant postopratively.