摘要
目的观察会阴各穿支血管的临床解剖,为会阴穿支皮瓣的设计提供参考。方法对经过处理的10具(20侧)尸体进行CT扫描,构建血管三维结构,然后对会阴区域的动、静脉进行解剖、测量、记录,最后建立模拟皮瓣,进而可设计出多种不同供应血管的穿支皮瓣。结果会阴穿支皮瓣动静脉丰富、邻近会阴部,是修复会阴部组织缺损和阴道再造的良好供区。依据会阴区穿支血管的走行、分布和各穿支间的吻合情况,可切取四种会阴穿支皮瓣:(1)以阴唇(囊)后动脉外侧支为蒂的会阴穿支皮瓣;(2)以闭孔动脉前皮支为蒂的会阴穿支皮瓣;(3)以阴部外动脉为蒂的会阴穿支皮瓣;(4)以闭孔动脉前皮支为蒂的会阴穿支皮瓣联合闭孔动脉股薄肌支为蒂的股薄肌肌皮瓣。结论会阴穿支皮瓣可用其行阴道等重要器官的再造,可修复会阴部皮肤组织缺损及较大缺损,可用于尿道下裂及阴道直肠瘘的修复,还可应用于游离移植。
Objective To study the clinical anatomy of perineal perforator vessels to provide theoretical basis for designing perineal perforator flap. Methods CT scans on 10 post-treatment corpses（ 20 sides） were performed,and vascular threedimensional structure was constructed,and then the autopsy,measurement and record of arteries and veins of perineal region were performed. Finally,the simulated skin flaps were established,and the perforator flaps of different vessels of blood supply were further designed. Results The perineal perforator flap was rich in arteries and veins and adjacent to perineal region,so it was the better donor site of repairing tissue defect of perineal region and vagina reconstruction. According to the running line and distribution of perforator vessels of perineal region and the anastomosis among various perforator vessels,four kinds of perineal perforator flap can be cut off： the perineal perforator flap. with lateral branch of abia（ scrotum） posterior artery as a pedicle,the perineal perforator flap with anterior cutaneous branch of obturator artery as a pedicle,the perineal perforator flap with external pudendal artery as a pedicle and the perineal perforator flap with anterior cutaneous branch of obturator artery as a pedicle combined with musculocutaneous flap with thigh thin muscular branch of obturator artery as a pedicle. Conclusions Perineal perforator flap can be used in the reconstruction of vagina and other important organs,repairing perineal skin tissue defect and larger defects,repairing hypospadias and rectovaginal fistula and free grafting.
出处
《中国临床研究》
CAS
2015年第9期1151-1153,共3页
Chinese Journal of Clinical Research
关键词
会阴穿支皮瓣
会阴穿支血管
闭孔动脉
阴唇(囊)后动脉
阴部外动脉
阴道再造
Perineal perforator flap
Perineal perforator vessel
Obturator artery
Abia （scrotum） posterior artery
Ex-ternal pudendal artery
Vagina reconstruction
