彩色多普勒超声在穿支皮瓣术前定位中的应用

Application of color Doppler ultrasound in preoperative vascular localization of perforator flaps

目的探讨彩色多普勒超声在穿支皮瓣术前定位中的应用价值。方法对64例行穿支皮瓣修复术患者,应用彩色多普勒超声诊断仪对皮瓣供区探查,重点记录穿支血管的体表定位、口径、血流信息,并通过分析比较以上信息,选择优势穿支,为术前皮瓣设计、术中对皮瓣解剖提供指导。结果 64例患者的动脉穿支从主干发出部位及其走行于超声下均可显示,选择其中条件良好的优势穿支平均口径>0.5 mm,血流峰速平均约16.4 cm/s,阻力指数平均0.7。术中探查所见优势穿支与术前超声检查结果吻合率为92.19%(59/64),超声定位的穿支血管采用率为96.88%(62/64)。结论彩色多普勒超声可准确指导穿支皮瓣的术前选择、皮瓣设计以及辅助手术方案的制定。

Objective To explore the application of color Doppler ultrasound in preoperative vascular localization of perforator flaps. Methods A total of 64 patients underwent perforator flap transplantation. Color Doppler ultrasound was used to identify the location, course, caliber, and hemodynamics of the artery perforators preoperatively, and the results were compared with intraoperative findings. Results The course and location of the perforator artery was recorded in each patient with an average diameter of 0.5 mm, the peak velocity of blood flow was 16.4 cm/s, and the resistance index was 0.7. The coincidence between the dominant perforating branches in the examination results of the preoperative color Doppler ultrasound and the operation exploration was 92.19% （59/64）. The adoption rate of the perforator vessels identified by preoperative color Doppler ultrasound was 96.88% （62/64）. Conclusion Color Doppler ultrasound can provide accurate data about the location, subcutaneous course, and caliber of perforator vessels, which can assist surgeons in selecting an appropriate perforator, donor site, and flap.