中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (38): 6141-6145.doi: 10.3969/j.issn.2095-4344.2014.38.013

• 组织构建基础实验 basic experiments in tissue construction • 上一篇    下一篇

高频超声引导下胸背动脉穿支移植皮瓣的设计

沈美华，阿里木江•阿不来提，艾合买提江•玉树甫，董  建，王  伟，刘亚飞   

  1. 新疆医科大学第一附属医院显微修复外科，新疆维吾尔自治区乌鲁木齐市  830054
  • 收稿日期:2014-07-21 出版日期:2014-09-10 发布日期:2014-09-10
  • 通讯作者: 艾合买提江?玉树甫，博士，主任医师，新疆医科大学第一附属医院显微修复外科，新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:沈美华，女，1977年生，江苏省海门市人，汉族，新疆医科大学在读硕士，主治医师，主要从事数字骨科、创伤修复研究。
  • 基金资助:

    2013年国家自然科学基金项目(81360270)

Thoracic dorsal artery perforating flap transplantation under high-frequency ultrasound guidance

Shen Mei-hua, Alimujiang Abulaiti, Aihemaitijiang Yushufu, Dong Jian, Wang Wei, Liu Ya-fei   

  1. Department of Microsurgery Repair, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2014-07-21 Online:2014-09-10 Published:2014-09-10
  • Contact: Aihemaitijiang Yushufu, M.D., Chief physician, Department of Microsurgery Repair, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Shen Mei-hua, Studying for master’s degree, Attending physician, Department of Microsurgery Repair, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81360270

PDF

493

被引次数

3

摘要：

背景：国内外最先进的、具有代表性的研究穿支血管的诊断学技术有数字减影血管造影、CT、MRI等影像技术。血管显影清楚、精准性高，但有一定的创伤，且不易普及。
目的：应用高频超声探测胸背动脉及其穿支血管，为胸背动脉穿支皮瓣的术前设计提供参考依据。
方法：对15例拟行胸背动脉穿支皮瓣的患者，术前用高频超声探测穿支血管，重点探测各穿支血管走形、直径、穿支的位置，并进行体表标记。选取直径粗、位置表浅、血管走行平直的穿支血管为主干血管，设计并切取皮瓣。
结果与结论：15例患者胸背动脉全部发自肩胛下动脉，胸背动脉及其主要分支以及13例大于1 mm的主干穿支显示清晰，并与术中测量结果基本吻合。小于1 mm的穿支血管仅能显示点条状血流信号或基本无血流及频谱信号，且与周围组织分辨不清。1例经术前探测发现血管扭曲、变异，改行其他手术。2例穿支血管术前非探及，经术中解剖发现并证实。结果表明高频超声在穿支血管术前体表定位方面作用显著，结合计算机辅助断层增强扫描或核磁辅助增强扫描等影像技术，可发挥更全面、可靠的参考价值。



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

关键词: 组织构建, 组织工程, 超声, 定位, 穿支皮瓣, 数字化, 影像技术, 手术导航, 国家自然科学基金

Abstract:

BACKGROUND: The most advanced and representative diagnosis techniques for perforating branch of blood vessels include digital subtraction angiography, CT, MRI and other imaging techniques. These methods can visualize blood vessels clearly and have a high precision, but there are some trauma and less popular.
OBJECTIVE: To apply high-frequency ultrasound for detection of thoracic dorsal artery and perforating branch, and provide a reference for preoperative design of thoracic dorsal artery perforating flap.
METHODS: Fifteen patients candidate for thoracic dorsal artery perforating flap were included in this study. Before surgery, we used high-frequency ultrasound to detect the perforating branch, including vascular contorts, diameter, the location of the perforators and surface markers. The thick, superficial, parallel perforating branch was selected as the main blood vessels, to design and cur the skin flap.
RESULTS AND CONCLUSION: In the involved 15 cases, thoracic dorsal artery were derived from the subscapular artery, thoracic dorsal artery and its main branches, as well as more than 1 mm main perforating branch in 13 cases were clearly visible. It was consistent with intraoperative measurement results. The perforating branch less than 1 mm only showed strip-like blood flow signal or no blood flow and spectrum signal, 
and there was an unclear boundary to surrounding tissue. One case appeared distortion and variation of blood vessels before surgery, thus changed to other surgery. Two cases had no perforating branch by preoperative detection, which was then confirmed by intraoperative anatomy. High-frequency ultrasound has a significant effect on preoperative position of perforating branch, and the combination with computer tomography angiography and magnetic resonance angiography can support a more comprehensive and reliable reference.



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

Key words: ultrasonography, surgical flaps, thoracic arteries, hemodynamics

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