超声多普勒血流仪在游离腓骨瓣皮岛设计中的应用

目的探讨超声多普勒血流仪在游离腓骨瓣皮岛设计中的应用价值.方法采用超声多普勒血流仪探测腓骨后缘中下份小腿外侧皮肤的腓动脉穿支,根据穿支的位置设计腓骨复合瓣的皮岛,结合术中所见情况进行比较,并观察术后皮岛的存活情况.结果3l侧腓骨后缘中下份的小腿外侧皮肤共测得腓动脉穿支89支(1～4支/侧,平均2.87支/侧),术中发现穿支的总数为87支(1～4支/侧,平均2.8支/侧),超声多普勒血流仪探测腓动脉穿支的准确率为91.0%,假阳性和假阴性率分别为8.98%和6.90%.皮岛面积最大12cm×8cm,最小3cm×1.5cm.3l例腓骨瓣中,1例因静脉血栓经抢救无效后去除,其余的30例均获得成活,所有的皮岛均获得100%成活.结论超声多普勒血流仪可以较为准确地探测到小腿外侧的腓动脉穿支血管,提高了游离腓骨瓣皮岛设计的准确性和可靠性,具有一定的临床应用价值.

The value of preoperative Doppler ultrasonography for planning skin paddles of free fibula flap

Objective To analyze the value of preoperative Doppler ultrasonography for planning skin paddles of free fibula flap.Methods The perforators of peroneal artery were detected using Doppler ultrasonography before taking free fibula flaps for 31 patients.The perforators located were marked,and their position relative to the lateral malleolus recorded.The results of preoperative Doppler ultrasonography were compared with that of operation.Results The accurate rate for preoperative Doppler ultrasonography was 91.0 %,with false positive rate of 8.98 %and false negative rate of 6.90 %.One free fibula flap was lost because of venous thrombosis,and the other 30 flaps survived completely,with 100% survival of all skin paddles.Conclusion The Doppler ultrasonography is a simple,reliable and readily available method for mapping the pefrorators,and design of the skin paddles more accurately.