股前区皮下脂肪厚度的测量及皮肤穿支血管的临床应用解剖研究
发布时间：2019-02-14 13:20
【摘要】： 目的 测量股前区不同部位的皮下脂肪厚度,解剖观察其皮肤穿支血管的分布、数量、类型、来源。为临床制备股前区单岛皮瓣及一蒂多岛皮瓣提供参考。 方法 选取2008年10月至2009年4月在中南大学湘雅二医院口腔颌面外科住院,行口腔颌面部恶性肿瘤切除术并Ⅰ期行左股前区游离皮瓣修复的患者66例。将股前区分为股前外侧区和股前内侧区,其再分为上、中、下3个区域。1.测量股前区各区域的皮下脂肪厚度。2.制备皮瓣过程中,利用制备皮瓣的切口,在尽量不增加对患者局部损伤的前提下,解剖观察左侧股前区各区域皮穿支血管的分布、数量、类型及来源。 结果 1.股前区皮下脂肪厚度下份＜中份＜上份,左右侧无明显差异,女性股前区皮下脂肪厚度大于男性。2.股前外侧区的上中下区域均有皮穿支血管分布,位于上份的占25.4%,中份的占34.7%,下份的占38.2%。中份出现皮穿支血管的概率(97%)＞下份(89.4%)＞上份(83.3%)。股前外侧区平均有4.4±1.4支皮穿支血管,下份的穿支血管数(1.9±0.8支)多于上份(1.4±0.5支)和中份(1.6±0.6支)。来源于降支的占76.3%,横支的占19.2%,升支的占1.4%,其它占3.1%,主要为肌皮穿支。3.股前内侧区的上中下区域均有皮穿支血管分布,位于上份的占17.1%,中份的占35.7%,下份的占46.3%。下份出现皮穿支血管的概率(95.5%)＞中份(84.9%)＞上份(51.5%)。皮穿支血管平均为3.3±1.1支,主要来源于股动脉及其分支,以肌皮穿支为主。57.6%的患者(38/66)股前内侧区的中、上份区域存在来源于旋股外侧动脉降支的皮穿支血管。 结论 1.股前区上下区域皮下脂肪厚度差异明显,下份＜中份＜上份。 2.股前区上、中、下区域均有穿支血管分布,可以根据临床需要制备不同厚度的皮瓣。 3.旋股外侧动脉及其分支所发出的皮穿支血管分布于股前区多个区域,可以根据所需皮瓣的大小选择不同区域的皮瓣进行组合,制备一蒂多岛皮瓣。
[Abstract]:Objective to measure the thickness of subcutaneous fat in different parts of prefemoral area and to anatomize the distribution, quantity, type and origin of perforating vessels. To provide reference for clinical preparation of single island flap of anterior femoral area and one pedicle island flap. Methods 66 patients who were hospitalized in oral and maxillofacial surgery from October 2008 to April 2009 in Xiangya second Hospital of Central South University underwent resection of malignant tumors of oral and maxillofacial region and repair of left anterior femoral free flap in the first stage. The anterior femoral area is divided into anterolateral femoral area and anterior medial femoral area, which is divided into 3 regions: upper, middle and inferior. 1. Measure the thickness of subcutaneous fat in the area of anterior femur. 2. During the preparation of the flap, the incision of the prepared flap was used to observe the distribution, quantity, type and origin of the perforating branches of the left prefemoral region without increasing the local injury to the patients. Result 1. There was no significant difference in the thickness of subcutaneous fat in the anterior femoral area between the left and the right, but the thickness of the subcutaneous fat in the anterior femoral area was greater in women than in men. There were cutaneous perforating branches in the superior middle and inferior areas of the anterolateral femoral area, which accounted for 25.4% in the superior part, 34.7 in the middle part and 38.2% in the next. The probability of cutaneous perforating vessels appeared in the middle (97%) was higher than that in the next (89.4%) > in the superior (83.3%). The average number of perforating vessels in the anterolateral femoral region was 4.4 卤1.4, and the number of perforating vessels in the inferior part (1.9 卤0.8) was higher than that in the superior (1.4 卤0.5) and the middle (1.6 卤0.6). The descending branch accounted for 76.3%, the transverse branch 19.2%, the ascending branch 1.4 and the others 3.1, mainly for the musculocutaneous perforating branch. There were cutaneous perforators in the superior middle and inferior areas of the anterior medial area of the femur, which were 17.1 in the superior, 35.7in the middle and 46.3 in the next. The probability of cutaneous perforating vessels was 95.5%, 84.9%, 51.5%, respectively. The average number of cutaneous perforator vessels was 3.3 卤1.1, mainly from femoral artery and its branches. 57.6% (38 / 66) of patients (38 / 66) were in the anterior medial femoral area. In the superior region, there are cutaneous perforators derived from the descending branch of lateral femoral circumflex artery. Conclusion 1. The thickness of subcutaneous fat in the upper and lower areas of prefemoral area was significantly different. 2. Perforating vessels are distributed in the prefemoral, middle and inferior femoral regions, and different thickness flaps can be prepared according to the clinical needs. 3. The cutaneous perforator vessels from lateral circumflex femoral artery and its branches are distributed in multiple regions of the anterior femoral area. According to the size of the required flap, the skin flap in different regions can be combined to produce a multi-island flap with one pedicle.
【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
本文编号：2422238
[Abstract]:Objective to measure the thickness of subcutaneous fat in different parts of prefemoral area and to anatomize the distribution, quantity, type and origin of perforating vessels. To provide reference for clinical preparation of single island flap of anterior femoral area and one pedicle island flap. Methods 66 patients who were hospitalized in oral and maxillofacial surgery from October 2008 to April 2009 in Xiangya second Hospital of Central South University underwent resection of malignant tumors of oral and maxillofacial region and repair of left anterior femoral free flap in the first stage. The anterior femoral area is divided into anterolateral femoral area and anterior medial femoral area, which is divided into 3 regions: upper, middle and inferior. 1. Measure the thickness of subcutaneous fat in the area of anterior femur. 2. During the preparation of the flap, the incision of the prepared flap was used to observe the distribution, quantity, type and origin of the perforating branches of the left prefemoral region without increasing the local injury to the patients. Result 1. There was no significant difference in the thickness of subcutaneous fat in the anterior femoral area between the left and the right, but the thickness of the subcutaneous fat in the anterior femoral area was greater in women than in men. There were cutaneous perforating branches in the superior middle and inferior areas of the anterolateral femoral area, which accounted for 25.4% in the superior part, 34.7 in the middle part and 38.2% in the next. The probability of cutaneous perforating vessels appeared in the middle (97%) was higher than that in the next (89.4%) > in the superior (83.3%). The average number of perforating vessels in the anterolateral femoral region was 4.4 卤1.4, and the number of perforating vessels in the inferior part (1.9 卤0.8) was higher than that in the superior (1.4 卤0.5) and the middle (1.6 卤0.6). The descending branch accounted for 76.3%, the transverse branch 19.2%, the ascending branch 1.4 and the others 3.1, mainly for the musculocutaneous perforating branch. There were cutaneous perforators in the superior middle and inferior areas of the anterior medial area of the femur, which were 17.1 in the superior, 35.7in the middle and 46.3 in the next. The probability of cutaneous perforating vessels was 95.5%, 84.9%, 51.5%, respectively. The average number of cutaneous perforator vessels was 3.3 卤1.1, mainly from femoral artery and its branches. 57.6% (38 / 66) of patients (38 / 66) were in the anterior medial femoral area. In the superior region, there are cutaneous perforators derived from the descending branch of lateral femoral circumflex artery. Conclusion 1. The thickness of subcutaneous fat in the upper and lower areas of prefemoral area was significantly different. 2. Perforating vessels are distributed in the prefemoral, middle and inferior femoral regions, and different thickness flaps can be prepared according to the clinical needs. 3. The cutaneous perforator vessels from lateral circumflex femoral artery and its branches are distributed in multiple regions of the anterior femoral area. According to the size of the required flap, the skin flap in different regions can be combined to produce a multi-island flap with one pedicle.
【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
【引证文献】
相关硕士学位论文 前1条
1 黄江;60例游离股前外侧肌皮瓣术后供区并发症及功能评价的研究[D];中南大学;2011年
，本文编号：2422238
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