臀区穿支皮瓣的应用解剖学研究.pdf

中国临床解剖学杂志2006年第24卷第2期·243·

·穿支皮瓣·
臀区穿支皮瓣的应用解剖学研究
胡斯旺,戴开宇,梅劲,唐茂林
(温州医学院解剖学教研室,浙江温州325035)

【摘要】目的:为臀区穿支皮瓣的临床应用提供解剖学基础。方法:6具(12侧)动脉灌注明胶-氧化铅
混悬液的新鲜成人整尸标本,解剖观测臀区外径≥0.5mm的穿支,测量其管径及其走行、分支、分布情况
等。取下整个臀区被覆组织拍摄X线片,观测皮动脉的数量以及彼此之间的吻合情况等。利用Photoshop
与ScionImage分析穿支供血的趋向性及每个分支的供血面积等。结果:臀上、臀下动脉直径≥0.5mm的
穿支数量分别为平均(5±2)支和(8±4)支,所有的臀上动脉和90%的臀下动脉的分支都是肌皮穿支,这些
穿支的平均内径为(0.6±0.1)mm。臀上、臀下动脉穿支在皮肤的平均分布范围分别是(69±56)cm2和(177±
38)cm2。臀上动脉穿支主要分布在髂后上棘和大转子的连线的内侧2/3;而臀下动脉的穿支多在臀区与臀
皱褶平行的水平中部1/3处。结论:臀区的皮肤穿支密集,营养皮肤面积较大,以臀上、臀下动脉穿支为蒂
设计的穿支皮瓣可用于乳房重建,骶骨、髋骨及会阴区重建等。
【关键词】臀上动脉;臀下动脉;穿支皮瓣;血管造影;乳房重建
【中图分类号】R616.2【文献标识码】A【文章编号】1001-165X(2006)03-0243-04

Appliedanatomyofthesuperiorandinferiorglutealarteryperforatorflaps
HUSi-wang,DAIKai-yu,MEIJin,etal.
DepartmentofAnatomy,WenzhouMedicalCollege,Wenzhou325035,China.
【Abstract】Objective:Tocomprehensivelyevaluatetheanatomicalbasisofthesuperiorandinferior
glutealarteryperforatorflapsandpresentanatomicallandmarksforfacilitatingflapdissection.Methods:Six
freshcadaversunderwentintra-arterialinjectionwithaleadoxideandgelatinepreparation.Theintegumentof
theglutealregionwasdissected.Cutaneousperforatorsofthesuperiorandinferiorglutealarterieswere
identified.Theircourse,size,location,andtype(septocutaneousvs.musculocutaneous)wererecordedby
dissection,angiographyandphotography.Thesurfaceareasofcutaneousterritoriesandperforatorzoneswere
measuredandcalculatedwithPhotoshopandScionImage.Results:Theaveragenumberofsuperiorandinferior
cutaneousperforators≥0.5mmintheglutealregionwas(5±2)and(8±4)respectively,withallofthesuperior
and90%oftheinferiorglutealarteryperforatorsbeingmusculocutaneous.Theiraverageperforatorinternal
diameterwas(0.6±0.1)mm.Theaveragesuperiorandinferiorglutealarterycutaneousvascularterritorywas(69
±56)cm2and(177±38)cm2.Thesuperiorglutealperforatorswerefoundadjacenttothemedialtwothirdsofa
linedrawnfromtheposteriorsuperioriliacspinetothegreatertrochanter.Theinferiorglutealarteryperforators
weremostlylocatedinthehorizontalmiddlethirdoftheglutealregionparalleltothegl