切断一侧血管后腓肠肌供血的影像及应用解剖

目的 探讨切断腓肠肌内侧或外侧血管对腓肠肌血供的影响,为临床应用吻合腓肠肌血管的游离皮瓣修复下肢皮肤软组织缺损提供理论依据.方法 用造影剂泛影葡胺灌注16侧结扎腓肠肌内侧或外侧血管后的新鲜成人下肢腘血管,进行横断面血管切割点的统计学分析;观测腓肠肌血管及其分支、管径、蒂部和交通支情况;制备动脉管道铸型标本,观察腓肠肌血管的血管分布情况.结果 在切断一侧腓肠肌血管的情况下.有来自腓肠肌内、外侧头之间的交通支和来自比目鱼肌交通支的血液供应该侧腓肠肌,其中来自比目鱼肌的交通支管径较粗,但数量少,且多出现在腓肠肌肌腹下1/3的位置,位置较恒定.腓肠肌内、外侧头之间的交通支主要出现在腓肠肌中下1/3,与腓肠神经营养血管轴相交通,外径多在0.5 mm以下.结论 腓肠肌的血供为多源性,结扎腓肠肌的内侧或外侧动脉后,腓肠肌完全可以通过吻合支获得足够的血液供应.

The anatomical and imageology study on the blood supply of the gastrocnemius after the ligating the medial or lateral vessel

Objective To investigate the effect to the blood supply of the gastrocnemius if ligating the medial or lateral artery, and provide theory base for the sural artery flap repairing the soft tissue defects of legs injuries.Methods The anatomical study involved 16 fresh adult cadaver lower legs ligating the medial or lateral gastrocnemius vessel, the arteries of which were perfused with the Meglumine Diatrizoatis Mucilage,and then carried out the cross-sectional analysis of the CTA, the bifurcation, location length, diameter and perforator of the sural artery were recorded by dissection.To observe the anastomosis with gastrocnemius vessel in artery pipeline foundry made by 1 specimen.Results The consistent with the result of the angiography was the gastrocnemius can completely get enough blood supply from some anastomotic arteriole when ligating one side of the sural vessel.Under normal circumstances, the blood supply of gastrocnemius muscle mainly supplied by sural artery.In the case of the sural vessel was cut off, the blood supply of gastrocnemius come from the anastomotic arteriole between medial and lateral artery and the soleus.The anastomotic arteriole from soleus has larger diameter, but less quantity, and was invariably deteced in the lower third of the gastrocnemius muscle constantly.A lot of anastomotic arteriole were found between the muscle heads, and it was also invariably deteced in the lower third of the gastrocnemius muscle, communicating with the surai neurovascular axis, the average external diameter was less than 0.5 mm.Conclusion The blood supply of the gastrocnemius are enough when ligating the medial or lateral artery.