彩色多普勒超声联合多层螺旋CT血管造影在穿支皮瓣术前定位中的应用

Application of color doppler ultrasound combined with multi-slice spiral CT angiography in preoperative localization of perforator flap

目的探讨彩色多普勒超声(CDS)联合多层螺旋CT血管造影(MDCTA)在穿支皮瓣术前定位中的应用价值。方法选取2017年12月至2019年12月在我院行旋股外侧动脉降支穿支皮瓣手术的患者78例,随机分为观察组和对照组,每组各39例,对照组予以MDCTA定位,观察组予以CDS联合MDCTA定位,比较两组术前定位与术中旋股外侧动脉降支穿支皮瓣穿出点的符合率、相差距离,同时观察术后1个月皮瓣的存活情况。结果观察组术前定位与术中利用穿支的符合率高于对照组,差异有统计学意义(P<0.05);观察组术前定位与术中相差距离低于对照组,差异有统计学意义(P<0.05);观察组术后1个月皮瓣存活率明显高于对照组,差异有统计学意义(P<0.05)。结论CDS联合MDCTA应用于穿支皮瓣术前定位中可以提高穿支血管定位的准确性,术后皮瓣存活率更高。

Objective To explore the application value of color doppler ultrasound(CDS)combined with multi-slice spiral CT angiography(MDCTA)in preoperative localization of perforator flap.Methods Seventy-eight patients who underwent perforator flap of descending branch of lateral femoral circumflex artery in our hospital from December 2017 to December 2019 were selected and randomly divided into the observation group(n=39)and the control group(n=39).MDCTA localization was given to the control group,and CDS combined with MDCTA localization was given to the observation group.The coincidence rate and distance gap of perforating point of perforator flap of descending branch of lateral femoral circumflex artery at preoperative localization and intraoperative localization were compared in the two groups,and the flap survival situation at 1 month after operation was observed.Results The coincidence rate of preoperative localization and intraoperative perforator use in the observation group was higher than that in the control group,with statically significant difference(P<0.05);the distance gap between preoperative localization and intraoperative localization in the observation group was lower than that in the control group,with statically significant difference(P<0.05);the flap survival rate at 1 month after operation in the observation group was higher than that in the control group,with statically significant difference(P<0.05).Conclusion The application of CDS combined with MDCTA in preoperative localization of perforator flap can improve the accuracy of perforator vessel localization,with a higher survival rate of the postoperative flap.