高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用_《中國修復重建外科雜志》

作者：

肖海濤 ¹ , 時瑩瑜 ² , 王懷勝 ¹ , 劉勇 ¹ , 張艷閣 ¹ , 岑瑛 ¹

關鍵詞：

高頻彩色多普勒超聲股前外側皮瓣穿支皮瓣

DOI：

10.7507/1002-1892.20130040

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的探討術前采用高頻彩色多普勒超聲檢測穿支血管在股前外側（anterolateral thigh，ALT）皮瓣手術中的應用價值。方法2011年2月－2012年7月，收治8例擬行ALT皮瓣修復手術的患者。男5例，女3 例；年齡21～46歲，平均34歲。其中頭皮鱗狀細胞癌術后缺損2例，頭皮撕脫傷2例，頸部外傷后皮膚軟組織壞死1例，腹股溝區隆突性纖維肉瘤術后缺損1例，腹股溝區黑色素瘤術后缺損1例，面部凹陷畸形1例。軟組織缺損范圍為12 cm × 7 cm～22 cm × 18 cm。術前采用高頻彩色多普勒超聲檢測旋股外側動脈降支穿支血管，選取管徑較粗、流速快、穿肌肉走行距離最短的穿支血管設計皮瓣，并將術前檢測結果與術中觀察情況進行比較。皮瓣切取范圍為14 cm × 9 cm～25 cm × 20 cm。供區均游離植皮修復。結果術前高頻彩色多普勒超聲檢測共發現皮瓣范圍內穿支血管19支，術中證實穿支血管18支，準確率為94.7%。術中見穿支血管出肌點及肌肉內走行方向與術前檢測基本一致。術后1例出現皮瓣下部分脂肪液化，經換藥2周后愈合；其余皮瓣均順利成活，創面均Ⅰ期愈合。供區植皮均成活。患者均獲隨訪，隨訪時間4～16 個月，平均8個月。皮瓣色澤、質地良好。結論ALT皮瓣術前應用高頻彩色多普勒超聲定位并選取合適的穿支血管能有效提高皮瓣切取的準確性。

引用本文： 肖海濤,時瑩瑜,王懷勝,劉勇,張艷閣,岑瑛. 高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用. 中國修復重建外科雜志, 2013, 27(2): 178-181. doi: 10.7507/1002-1892.20130040 復制

1.	李利平, P. C. Neligan. 股前外側游離穿支皮瓣修復頭面部和四肢腫瘤切除后軟組織缺損. 中國修復重建外科雜志, 2007, 21(4): 340-342.
2.	Rozen WM, Ashton MW, Pan WR, et al. Anatomical variations in the harvest of anterolateral thigh flap perforators: a cadaveric and clinical study. Microsurgery, 2009, 29(1): 16-23.
3.	Tang CL, Wu YC, Lai CH, et al. Salvage for pectoralis major myocutaneous flap failure in head and neck reconstruction by microvascular flap. J Plast Surg Hand Surg, 2012, 46(5): 335-338.
4.	Tsuchiya S, Nakatsuka T, Sakuraba M. One-sided soft palatal reconstruction with an anterolateral thigh fasciocutaneous flap: Report of two cases. Microsurgery, 2011, 31(2): 150-154.
5.	Kayano S, Sakuraba M, Miyamoto S, et al. Comparison of pedicled and free anterolateral thigh flaps for reconstruction of complex defects of the abdominal wall: Review of 20 consecutive cases. J Plast Reconstr Aesthetic Surg, 2012, 65(11): 1525-1529.
6.	Liang CC, Jeng SF, Yang JC, et al. Use of anteromedial thigh flaps as an alternative to anterolateral thigh flaps for reconstruction of head and neck defects in cancer patients. Ann Plast Surg, 2012. [Epub ahead of print].
7.	Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck, 2004, 26(9): 759-769.
8.	劉會仁, 李瑞國, 高順紅, 等. 股前外側皮瓣的多普勒探測研究和設計改進. 中國修復重建外科雜志, 2006, 20(7): 722-724.
9.	Masia J, Kosutic D, Clavero JA, et al. Preoperative computed tomographic angiogram for deep inferior epigastric artery perforator flap breast reconstruction. J Reconstr Microsurg, 2010, 26(1): 21-28.
10.	Knobloch K, Gohritz A, Reuss E, et al. Preoperative perforator imaging in reconstructive plastic surgery: current practice in Germany. Plast Reconstr Surg, 2008, 121(1): 183e-184e.
11.	任義軍, 任高宏, 金丹, 等. 數字化股前外側皮瓣的可視技術在臨床中的初步應用. 中華創傷骨科雜志, 2008, 10(5): 432-435.
12.	陸聲, 徐永清, 張元智, 等. CT血管造影及可視化研究在背闊肌肌皮瓣移植中的臨床應用. 中國修復重建外科雜志, 2009, 23(7): 818-821.
13.	Cheng HT, Lin FY, Chang SC. Evaluation of diagnostic accuracy using preoperative handheld Doppler in identifying the cutaneous perforators in the anterolateral thigh flap: A systematic review. Plast Reconstr Surg, 2012, 129(4): 769e-770e.
14.	Heo C, Eun S, Bae R, et al. Distally based anterolateral-thigh (ALT) flap with the aid of multidetector computed tomography. J Plast Reconstr Aesthet Surg, 2010, 63(5): e465-468.
15.	Tsukino A, Kurachi K, Inamiya T, et al. Preoperative color Doppler assessment in planning of anterolateral thigh flaps. Plast Reconstr Surg, 2004, 113(1): 241-246.
16.	陸林國, 徐智章, 劉吉斌, 等. 超聲造影增強技術在探索穿支皮瓣血管中的應用. 上海醫學影像, 2010, 19(3): 161-164.
17.	陸林國, 徐秋華, 燕山, 等. 高頻彩超對穿支皮瓣血管的探索研究. 上海醫學影像, 2008, 17(3): 200-202.
18.	Cigna E, Minni A, Barbaro M, et al. An experience on primary thinning and secondary debulking of anterolateral thigh flap in head and neck reconstruction. Eur Rev Med Pharmacol Sci, 2012, 16(8): 1095-1101.

1. 李利平, P. C. Neligan. 股前外側游離穿支皮瓣修復頭面部和四肢腫瘤切除后軟組織缺損. 中國修復重建外科雜志, 2007, 21(4): 340-342.
2. Rozen WM, Ashton MW, Pan WR, et al. Anatomical variations in the harvest of anterolateral thigh flap perforators: a cadaveric and clinical study. Microsurgery, 2009, 29(1): 16-23.
3. Tang CL, Wu YC, Lai CH, et al. Salvage for pectoralis major myocutaneous flap failure in head and neck reconstruction by microvascular flap. J Plast Surg Hand Surg, 2012, 46(5): 335-338.
4. Tsuchiya S, Nakatsuka T, Sakuraba M. One-sided soft palatal reconstruction with an anterolateral thigh fasciocutaneous flap: Report of two cases. Microsurgery, 2011, 31(2): 150-154.
5. Kayano S, Sakuraba M, Miyamoto S, et al. Comparison of pedicled and free anterolateral thigh flaps for reconstruction of complex defects of the abdominal wall: Review of 20 consecutive cases. J Plast Reconstr Aesthetic Surg, 2012, 65(11): 1525-1529.
6. Liang CC, Jeng SF, Yang JC, et al. Use of anteromedial thigh flaps as an alternative to anterolateral thigh flaps for reconstruction of head and neck defects in cancer patients. Ann Plast Surg, 2012. [Epub ahead of print].
7. Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck, 2004, 26(9): 759-769.
8. 劉會仁, 李瑞國, 高順紅, 等. 股前外側皮瓣的多普勒探測研究和設計改進. 中國修復重建外科雜志, 2006, 20(7): 722-724.
9. Masia J, Kosutic D, Clavero JA, et al. Preoperative computed tomographic angiogram for deep inferior epigastric artery perforator flap breast reconstruction. J Reconstr Microsurg, 2010, 26(1): 21-28.
10. Knobloch K, Gohritz A, Reuss E, et al. Preoperative perforator imaging in reconstructive plastic surgery: current practice in Germany. Plast Reconstr Surg, 2008, 121(1): 183e-184e.
11. 任義軍, 任高宏, 金丹, 等. 數字化股前外側皮瓣的可視技術在臨床中的初步應用. 中華創傷骨科雜志, 2008, 10(5): 432-435.
12. 陸聲, 徐永清, 張元智, 等. CT血管造影及可視化研究在背闊肌肌皮瓣移植中的臨床應用. 中國修復重建外科雜志, 2009, 23(7): 818-821.
13. Cheng HT, Lin FY, Chang SC. Evaluation of diagnostic accuracy using preoperative handheld Doppler in identifying the cutaneous perforators in the anterolateral thigh flap: A systematic review. Plast Reconstr Surg, 2012, 129(4): 769e-770e.
14. Heo C, Eun S, Bae R, et al. Distally based anterolateral-thigh (ALT) flap with the aid of multidetector computed tomography. J Plast Reconstr Aesthet Surg, 2010, 63(5): e465-468.
15. Tsukino A, Kurachi K, Inamiya T, et al. Preoperative color Doppler assessment in planning of anterolateral thigh flaps. Plast Reconstr Surg, 2004, 113(1): 241-246.
16. 陸林國, 徐智章, 劉吉斌, 等. 超聲造影增強技術在探索穿支皮瓣血管中的應用. 上海醫學影像, 2010, 19(3): 161-164.
17. 陸林國, 徐秋華, 燕山, 等. 高頻彩超對穿支皮瓣血管的探索研究. 上海醫學影像, 2008, 17(3): 200-202.
18. Cigna E, Minni A, Barbaro M, et al. An experience on primary thinning and secondary debulking of anterolateral thigh flap in head and neck reconstruction. Eur Rev Med Pharmacol Sci, 2012, 16(8): 1095-1101.

《中國修復重建外科雜志》

高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國修復重建外科雜志》

高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料