小腿肌间隙皮支血管与肌间组织解剖关系及其临床意义

Study of the anatomical relationship between the cutaneous rami of vascular in intermuscular space and the intermuscular tissues and its clinical significance

目的:研究肌间隙皮瓣皮支血管与肌间组织的解剖关系,探索更安全、合理的皮瓣切取模式。方法:尸体解剖和在手术中观察肌间隙皮支与肌间组织的关系。结果:①肌间隙皮支血管从肌间组织的侧方爬行而非从其中间穿行;②从肌间组织的一侧(血管爬行侧)能清楚地看到皮支血管走行及其穿深筋膜浅出点,而从另一侧看不清或看不到;③某些肌间隙肌间组织两侧皆有血管爬行,但其两侧皮支血管分属不同的主干血管;④肌间隙皮支血管与其主干血管同处于肌间组织的一侧。结论:皮瓣切取时,先从皮支血管穿出侧解剖游离,能更容易地找出皮支血管,提高皮瓣切取的成功率。

Objective: To seek a more safe and reasonable method to cut the flap and to study the anatomical relationship between the cutaneous rami of vascular in intermuscular space (VCRIS) flap and the intermuscular tissues (IT). Method: Autopsy or observation in operation. Results: ①The VCRIS didn't cross among the IT but passed by the lateral side of IT. ② The VCRIS and their superficial sites of perforating aponeurotic fasciae can be seen unclearly or can not be seen from one side but clearly from another side. ③ There were blood vessels running at both sides of intermuscular tissues of some intermuscular space, but its bilateral VCR belonged to different chief trunks respectively. ④ The VCIRS and its chief trunk were located together in one side of IT. Conclusion: The flap should be incised first at the side from which the VCR perforates out.