以损伤血管束为蒂的前臂逆行岛状皮瓣移植术前超声诊断

Preoperative ultrasonography of retrograde island flap supplied by injured artery of forearm

目的 探讨通过术前超声检查判断以损伤血管束为蒂的前臂岛状皮瓣移植术的适应症。方法 新鲜成人上肢标本 6例 ,直视下进行解剖观察 ,记录上肢尺动脉和桡动脉的交通支及筋膜血管网。手及腕部尺、桡动脉损伤患者 15名 ,自损伤部位近侧 3cm处作为检查部位 ,彩色超声仪的浅表器官探头检查血管直径及血流速度 ,并计算与健侧的比值。结果 在尺动脉、桡动脉及手部各动脉之间还有大量的、管径不一的动脉直接及间接交通支 ;8例腕部切割伤的损伤血管部位附近的血管直径及血流速均较大 ,而 4例腕部及前臂严重广泛挤压伤及 3例电击伤的上述 2项指标均有明显下降。结论 该术式的适应症为腕部切割伤等损伤范围局限的损伤。电击伤及前臂广泛挤压伤等应慎重采用该术式。

Objective to study the indications for retrograde island flap supplied by injured artery of forearm by means of preoperative ultrasonic examination. Methods ulnar and radial arteries, their communicating branches and tiny fascial vessels of 6upper limbs on fresh adult cadavers were observed; diameter and blood velocity of 15 injured ulnar of radial arteries were examined by ultrasonography.Results there are many direct or indirect communicating branches between ulnar, radial and other arteries;diameter and blood velocity of 8 simply cut arteries remain relatively high values, but decrease significantly in arteries injured by severe crush trauma and electric injuries.Conclusions the indications for retrograde island artery of forearm is locally injured arties, and the arteries injured by severe crush trauma and electric injury should not be used as donors.