【作者】 龚朝建； 吴汉江； 朱兆夫； 刘金兵； 吴湘卿； 王志平； 段红明； 王铠； 谭宏宇； 张胜； 李运良；

【Author】 GONG Zhao-jian,WU Han-jiang,ZHU Zhao-fu,LIU Jin-bing,WU Xiang-qing,WANG Zhi-ping,DUAN Hong-ming, WANG Kai,TAN Hong-yu,ZHANG Sheng,LI Yun-liang. (Department of Stomatology,Xiangya Second Hospital,Central South University,Changsha 410011,China)

【机构】 中南大学湘雅二医院口腔中心颌面外科；

【摘要】 目的:通过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、类型及来源,探讨在股前区不同区域制备不同厚度股前外侧皮瓣的可行性,并为多叶皮瓣的制备提供参考。方法:选取2008年10月至2009年4月我科采用左股前区游离皮瓣修复口腔颌面部恶性肿瘤术后缺损的患者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。测量各区域的皮下脂肪厚度并解剖观察左侧股前区皮肤穿支血管的分布、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。2.股前外侧区上、中、下份区域出现穿支血的概率分别为83.3%,97%,89.4%。皮穿支血管平均为4.4±1.4支,来源于降支的占76.3%,横支19.2%,升支1.4%,其它3.1%。3.股前内侧区上、中、下份区域出现穿支血管的概率分别为51.5%,84.9%,95.5%。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)股前内侧区存在来源于降支的皮穿支血管。结论:股前区上、下区域皮下脂肪厚度差异明显,下份<中份<上份;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;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,可以选择不同区域的皮瓣进行组合,制备多叶皮瓣。更多还原

【Abstract】 Objective:To measure the thickness of subcutaneous fat in different parts of anterior thigh region and explore the distribution, number,types and sources of cutaneous perforators in anterior thigh region.To discuss the feasibility of making the anterolateral thigh flap which has different thickness in different parts of anterior thigh region and provide clinical guidance on making polyfoliate flap.Methods:66 patients from October.2008 to April.2009 were selected.They all underwent the reconstruction with free flaps of left anterior thigh region following the resection of oral and maxillofacial malignant.The anterior thigh region was divided into anterolateral thigh region and anteromedial thigh region,which were further divided into upper,middle and lower regions.To measure the thickness of subcutaneous fat in different parts of anterior thigh region and explore the perforator’s distribution,number,types and sources in left anterior thigh region.Results:1.In anterior thigh region,the thickness of subcutaneous fat of the lower part<the middle part<the upper part.2.The probability of cutaneous perforators in the upper part of anterolateral thigh region was 83.3%,the middle part was 97%,the lower part was 89.4%.The average cutaneous perforators of anterolateral thigh region was 4.4±1.4.Among the cutaneous perforators,76.3%arised from descending branch,19.2%from transverse branch,1.4%from ascending branch,3.1%from other vessels.3.The probability of cutaneous perforators in the upper part of anteromedial thigh region was 51.5%,the middle part was 84.9%,the lower part was 95.5%.The average cutaneous perforators of anteromedial thigh region was 3.3±1.1.The cutaneous perforators were mainly arised from the femoral artery and its branches,most of them were musculocutaneous perforators.57.6%of the patients (38/66)had cutaneous perforators which arised from descending branch in the anteromedial thigh region.Conclusions:Among different parts of anterior thigh region,the difference of thickness of subcutaneous fat is obvious,the lower part<the middle part<the up- per part.All of the lower,middle and upper parts of anterior thigh region have cutaneous perforators.We can make the flap which has different thickness in different parts.The cutaneous perforators which arise from the lateral circumflex femoral artery and its branchs are distributed in many parts of anterior thigh region.During the process of making polyfoliate flap,we can choose flaps from different regions.更多还原