臀上、下动脉穿支皮瓣解剖学研究及临床应用

发布时间：2018-03-31 23:18

本文选题：臀上、下动脉穿支皮瓣　切入点：褥疮　出处：《中南大学》2009年硕士论文

【摘要】： 整形外科的精髓就是皮瓣,修复与重建,组织器官再造都需要皮瓣。过去的一个世纪以来按皮瓣血循环的类型将皮瓣分为任意型和轴型。随着人类解剖学知识和显微技术的不断发展,传统的肌皮瓣和筋膜皮瓣逐渐进化成穿支皮瓣。研究显示,穿支皮瓣无需携带肌肉,也不需皮瓣下的筋膜血管网,只需仔细解剖出肌皮穿支血管来确保皮瓣的成活,这大大降低了供瓣区的并发症。肌皮穿支皮瓣代表了一个崭新的整形显微外科的进展方向,它用单纯的组织瓣修复皮肤软组织的缺损,保留了供瓣区肌肉的完整性。研究目的: 通过血管灌注,显微解剖的方法,进一步明确臀上、下动脉走行、分支和臀上、下动脉穿支在臀大肌及筋膜区的分布情况。为臀上、下动脉穿支皮瓣的临床应用提供解剖学依据。临床研究方面,总结臀上、下动脉穿支皮瓣修复褥疮病例,评价臀上、下动脉穿支皮瓣在修复褥疮手术中的临床意义,并评价臀上、下动脉穿支皮瓣的应用价值。研究方法: 1)应用血管灌注、显微解剖方法,对于6具1 2侧臀部标本进行观察、测量。 2)对应用臀上、下动脉穿支皮瓣修复褥疮病例进行总结,随访,统计供区及修复褥疮并发症发病率,以及进行满意度调查。研究结果: 臀区主要穿支的基本测量(x±s) 术后患者对供区疤痕、臀部整体外形、褥疮的未复发都给与了充分的肯定,对皮瓣的外形和生活质量的改善都给了非常高的评价。研究结论: 臀上、下动脉穿支皮瓣血运可靠,损伤小,供区隐蔽,是应用前景较大的皮瓣。
[Abstract]:The essence of plastic surgery is flap repair and reconstruction. Tissue and organ reconstruction requires flaps. Over the past century, flaps have been divided into arbitrary and axial types according to the type of blood circulation of the flaps. Traditional myocutaneous flaps and fascial flaps have evolved into perforating branch flaps. Studies have shown that perforating branch flaps do not need to carry muscle or fascial vascular network under the flap, but only need to carefully dissect the musculocutaneous perforating branch vessels to ensure the survival of the flap. The musculocutaneous perforator flap represents a new direction of plastic microsurgery. It uses a simple tissue flap to repair the skin and soft tissue defects and preserves the muscle integrity of the donor flap area. Objectives of the study:. The distribution of the superior gluteal artery, the inferior artery, the branches of the inferior artery and the perforating branch of the inferior artery in the gluteus maximus and fascia were further determined by the method of blood vessel perfusion and microdissection. The clinical application of perforating branch flap of inferior artery provides anatomic basis. In clinical research, we summarize the clinical significance of superior and inferior breech artery perforator flap in the repair of bedsore, and evaluate the value of superior and inferior breech artery perforating branch flap in the repair of bedsore. Research methods:. 1) Vascular perfusion and microdissection were used to observe and measure 12 buttocks of 6 animals. 2) to summarize and follow up the patients with bedsore with superior and inferior breech artery perforator flaps, to investigate the incidence of complications in donor area and repair of bedsore, and to investigate the satisfaction degree. Results of the study:. Basic measurement of the main perforating branch in the gluteal area (x 卤s). After operation, the donor scar, the overall shape of the buttocks, the non-recurrence of bedsore were fully affirmed, and the improvement of the appearance and quality of life of the flap were highly evaluated. The study concluded that:. The superior inferior artery perforator flap is a promising flap with reliable blood circulation, small injury and hidden donor area.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R322;R622

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