【摘要】 目的:分析应用超声血流探测实施腓肠肌神经营养皮瓣修复小腿下段皮肤软组织缺损的临床效果。方法:回顾性分析笔者医院2014年1月-2015年1月,收治的30例小腿下段皮肤软组织缺损患者为研究对象,均应用超声血流探测实施腓肠肌神经营养皮瓣修复,并在显微镜的介导下,吻合腓肠肌神经近端与小腿部缺损创面处的胫神经,吻合小隐静脉与大隐静脉。分析本组患者的临床效果,随访2年,进一步分析患者的预后。结果:本组30例患者均顺利完成手术,术前超声血流探测,腓肠肌神经营养皮瓣的穿支动脉内径为(0.89±0.25)mm,收缩期峰值流速为(0.19±0.07)m/s,皮瓣筋膜蒂长度为(8.40±3.29)cm,术后创面均一期愈合,随访2年,修复创面的皮瓣均恢复良好,下肢活动功能恢复满意。随访期间,患者修复皮瓣感觉良好,显著恢复皮肤感觉,两点辨别觉最小10mm,最大15mm,平均(11.2±0.25)mm。结论:应用超声血流探测进行腓肠肌神经营养皮瓣设计,可覆盖小腿下段皮肤软组织缺损,重建感觉功能,且皮瓣存活率高、预后良好,可作为修复小腿下段皮肤软组织缺损的理想选择。更多还原

【Abstract】 Objective To analyze the clinical effect of using gastrocnemius nerve nutirent flap to repair skin and soft tissue defects of the lower leg.Methods Retrospective analysis of our patients from January 2014 to January 2015,30 cases of treatment for skin and soft tissue defects of the lower leg.Under the guidance of microscope,the proximal end of gastrocnemius nerve was anastomosed with the tibial nerve at the defect of leg,and the saphenous vein and great saphenous vein were anastomosed.Analysis of the clinical effect of this group of patients,followed up for 2 years,further analysis of the prognosis of patients.Results 30 patients were successfully completed the surgical operations,ultrasonic blood flow detection before operations,inner diameter of perforating artery of gastrocnemius neurotrophic flap was (0.89±0.25)mm,peak systolic blood flow velocity was (0.19±0.07)m/s,length of flap fascial pedicle was (8.40±3.29)cm,all the wounds were healed at one stage after operation,followed-up for 2 years,the flaps recovered well and the lower limb movement function recovered satisfactorily,during the follow-up period,the skin sensation was significantly restored,with two point discrimination of minimum 10 mm,maximum 15 mm,average (11.2±0.25)mm.Conclusion The design of gastrocnemius nerve nutrition flap with ultrasonic blood flow detection can cover the skin and soft tissue defects of the lower leg,reconstruct the sensory function,and the flap has high survival rate and good prognosis,which can be used as an ideal choice to repair the skin and soft tissue defects of the lower leg.更多还原