股前外侧部皮瓣的进一步解剖学研究——高位皮动脉与皮瓣血供的分型

High cutaneous artery branches and blood supply types of the anterolateral thigh flap: a farther anatomic study

目的 :研究股前外侧皮瓣高位皮动脉及皮瓣的血供类型。方法 :在 50侧灌注红色乳胶的成人防腐标本上对股前外侧部皮动脉进行解剖观察 ,记录高位皮动脉的出现率、来源动脉、位置及其走行 ,分析股前外侧部皮动脉的分布规律。结果 :高位皮动脉出现率为 58% (2 9侧 ,34支 ) ,其中发自旋股外侧动脉升支的占 1 0 % (5侧 )、横支的占 44 % (2 2侧 )和降支根部的占 4 % (2侧 )。无高位皮动脉出现时 ,旋股外侧动脉降支发出皮动脉营养皮瓣 ,降支皮动脉浅出点在髂髌连线附近 ,可定为正常型 (2 1侧 ,42 % )。出现高位皮动脉时 ,降支发出的皮动脉位置偏低 ,管径较细 ,皮瓣的血供可分为降支皮动脉主要型 (1 8侧 ,36 % )、均匀分布型 (6侧 ,1 2 % )和高位皮动脉支主要型 (5侧 ,1 0 % )。结论 :高位皮动脉出现率高 ,分布具有规律性 。

Objective: To further study the applied anatomy of the high cutaneous artery branches and blood supply types of the anterolateral thigh flap. Methods: The cutaneous arteries of the anterolateral thigh were dissected in 50 sides of the adult preservated cadaveric specimens perfused with red relax, the occurrence rate, source artery and the course of the high cutaneous branches were noted and the distribution characteristics wers analyzed. Results: Thirty-four high cutaneous artery branches occurred in 29 of 50 sides of adult cadavers and the occurrence rate thereof was 58%. The high cutaneous branches came from the ascending branch (10%, 5 sides), transverse branch (44%, 22 sides) or the root of the descending branch(4%, 2 sides) of the lateral femoral circumflex artery. The type of blood supply in the skin of anterolateral thigh could be defined as normal type(42%, 21 sides), descending ramus dominant type(36%,18 sides), equilibration type(12%,6 sides) and high ramus dominant type(10%,5 sides). Conlusion: The high cutaneous branches and its source artery could be adopted as a supplementary pedicle for the anterolateral thigh flap because of its high occurrence rate and distribution regularity.