浅层腹壁静脉系统的血管构造研究及其意义
Applied anatomy of the venous vascular structure in the superficial abdomen
目的 应用放射学及解剖学方法研究腹壁浅层静脉系统的血管构造。 方法 取10个新鲜尸体腹壁标本（20侧），从腹壁浅静脉将X线显影剂灌注入皮瓣，在灌注过程中应用三维CT进行扫描，将所获得的数据在CT工作站上进行图像重建与分析。在CT扫描完毕后对标本静脉进行蓝色颜料灌注及解剖，并与放射学研究结果进行对比。 结果 ⑴腹壁浅静脉起源于脐周，斜向外下走向大隐静脉或股静脉；⑵腹壁浅静脉走行层次位于Scarpa筋膜浅层，靠近皮肤，走行深度为0.27~0.41；⑶腹壁深浅静脉吻合主要集中在脐周区域，可见腹壁下静脉的直接穿支与腹壁浅静脉相吻合。 结论 ⑴腹壁浅静脉是浅层腹壁的优势回流静脉；⑵了解浅层腹壁静脉系统对腹部皮瓣尤其是DIEP皮瓣的选择、修薄有指导意义。
Objective To explore the anatomy of the venous vascular structure in the superficial abdomen using the method of radiology and cadaveric anatomy. Methods Ten abdominal specimens harvested from fresh cadavers were cannulated with trocar and injected with contrast medium into the superficial inferior epigastric vein. During the perfusion of the contrast medium in the flap, the abdominal wall was scanned by three-dimensional CT (four-dimensional defined as three dimensional CT plus time). The CT data was sent to CT workstation and the images were processed and reformatted. The result was compared with that of specimen dissection after injection of blue dye from the vein. Results Originated from paraumbilical area, the superficial inferior epigastric vein coursed obliquely to great saphenous vein of femoral vein; The superficial inferior epigastric vein located longitudinally in a plane above the Scarpa's fascia, with a subcutaneous depth of 0.27~0.41; There were obvious anastomoses existing around the paraumbilical area between the superficial inferior epigastric vein and the largest vein perforator from deep inferior epigastric vein. Conclusions It is the main draining vein of the superficial anterior abdominal wall which is confirmed by its course, diameter and distribution. The knowledge of venous drainage in the superficial anterior abdomen helps to plan DIEP flap and guide flap thinning.
CT血管显影 / 腹壁浅静脉 / 腹壁下静脉 / 腹壁下动脉穿支皮瓣
Computed tomography angiography（CTA） / Superficial inferior epigastric vein / Deep inferior epigastric vein
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