中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (1): 22-25.doi: 10.13418/j.issn.1001-165x.2018.01.006

• 断层影像解剖 • 上一篇    下一篇

高频彩色多普勒超声在股前内侧穿支血管的检测及其临床应用评价

郑炜1,  王宏宇 2, 程天平1, 李向云 1, 姬冬辉1, 张涛1, 张艳1, 左江华1, 程芳1, 何润之1   

  1. 1.邢台市人民医院,  河北   邢台    054031; 2.中国人民解放军第二五四医院,  天津   300020 
  • 收稿日期:2017-05-17 出版日期:2018-01-25 发布日期:2018-03-06
  • 通讯作者: 王宏宇,主治医师,医学硕士,Tel:(022)84683114, E-mail:tjwhy87@163.com
  • 作者简介:郑炜(1983-),男,河北邢台人,主治医师,医学硕士,主要从事整形烧伤方面的研究工作,Tel:(0319)3286121,E-mail:49864370@qq.com

Study on application value of high frequency color Doppler ultrasound for exploring femoral anterior-medial side perforator artery flap

ZHEN Wei1, WANGHong-Yu2, CHEN Tian-ping1, LI Xiang-yun1, JI Dong-hui1, ZHANG Tao1, ZHANG Yan1, ZUO Jiang-hua1, CHENG Fang1, HE Run-zhi1   

  1. 1.The Xingtai People's Hospital of Hebei Province, Hebei 054000; 2.Chinese People's Liberation Army No. 254 Hospital, Tianjin 300020, China
  • Received:2017-05-17 Online:2018-01-25 Published:2018-03-06

摘要:

目的 探讨高频彩色多普勒超声在术前股前内侧穿支定位以及术后监测血流动力学指标中的应用价值。   方法 选择56例皮肤软组织缺损患者行穿支皮瓣修复术;采用高频彩色多普勒超声术前对股前内侧穿支进行探查,在术前和术后第1、3、5、7、14、30天的不同时间点测量穿支动脉的内径,血流量和血流动力学参数(Vmax,Vmin,PI和RI)。  结果 56例患者共检测到股动脉优势穿支动脉102支,股动脉穿支动脉Vmin,Vmax,血流量和内径在术后第1、3、5、7天逐渐上升,到术后第14、30天表现为下降,但均比术前升高,有统计学差异(P<0.05);PI和RI在术后第1、3、5、7和14天逐渐降低,术后第30天略有上升,但均比术前降低,有统计学差异(P<0.05)。 结论 采用高频辨彩色多普勒超声探查可以直观显示股前内侧股动脉穿支血管的体表定位及血流动力学特点,有助于更好地指导皮瓣术前设计以及早期发现血管危险和评估预后。

关键词: 彩色多普勒超声,  股动脉穿支皮瓣,  修复重建外科手术

Abstract:

Objective To explore the application value of high-frequency color Doppler ultrasound for marking the femoral anterior-medial side perforator artery before operation and monitoring of postoperative haemodynamics.  Methods  56 patients with skin and soft tissue defect underwent perforator flap reconstruction. The high frequency color Doppler ultrasound was used to examine femoral anterior-medial side perforator artery before operation. The diameter, blood flow and haemodynamics indexes (Vmax,Vmin,PI and RI)of the perforator artery were detected before the operation and at 1th,3rd, 5th, 7th, 14th and 30th day after the operation. Results There were 102 good femoral perforator arteries at the anterior-medial side of 56 thighs. The diameter, Vmax, Vmin and flow of the perforator artery gradually increased at the 1st, 3rd, 5th and 7th day after the operation, and decreased at the 14th and 30th day. The diameter, Vmax, Vmin and flow of the perforator artery after operation were higher than those before operation, and there were significantly statistic differences between them.The PI and RI gradually decreased at the 1st, 3rd, 5th, 7th and 14th day after operation and then increased at the 30th day. The PI and RI of the perforator artery after operation were lower than those before operation, and there were significantly statistic differences between them.  Conclusion  High frequency color Doppler ultrasound could visually display body surface localization and haemodynamics indexes of femoral anterior-medial side perforator artery, which could better provide guidance for design before operation for flap, and detect the vascular crisis early and evaluate the prognosis.

Key words: Color Doppler ultrasound,  Femoral perforator artery flap,   Restorative and reconstructive surgery