尺动脉穿支皮瓣的应用解剖学研究

目的　为尺动脉穿支皮瓣的临床应用提供解剖学依据。 方法　观察10具动脉铸型标本。取新鲜成人尸体25具(50侧)，行一次性全身动脉造影。通过直接层次解剖，应用图像分析和测量系统Scion image，对前臂内侧区穿支进行定性、定量分析；螺旋CT扫描数据以Dicom 格式输入Mimics 图像工作站，对尺动脉穿支皮瓣进行三维重建。 结果　该区共有外径≥0.5mm 的穿支(7.0±2.0)支，外径(0.6±　0.2) mm，蒂长(2.7±1.4)cm，单穿支的供血面积(26.0±7.0)cm2。尺动脉除在远端发出粗大的尺动脉腕上皮支，在肱骨内上髁以下8～10cm处也有较粗、恒定的穿支，尺动脉多个穿支相互吻合形成前臂内侧血管链。 结论　可以尺动脉近端穿支为基础设计游离皮瓣，以内侧血管链为基础设计长而窄的增压穿支皮瓣也是切实可行的。

Applied anatomy of the ulnar artery perforator flap

Objective　To provide morphological data that enables safe elevation of the ulnar artery perforator flap.　Methods　 The anteromedial forearm perforators were studied in 25 fresh cadavers and 10 cast preparations. Cadavers were injected with lead oxide for three-dimensiona reconstruction. The origin, course, and distribution of the perforators in the anteromedial forearm region were comprehensively documented.　Results　There were 7.0±2.0 ulnar artery perforators in the anteromedial forearm. The average e xternal diameter was 0.6±0.2 mm. Each perforator supplied an average area of (26.0±7.0) cm2. Extensive anastomoses were found between the ulnar artery perforators and multiple adjacent source arteries.　Conclusions　The main advantages of the proximal ulnar artery perforator flap is that it is a thin flap which is ideal for upper extremity reconstruction, either as a proximally or distally based local perforator flap or as a free flap. The donor site is excellent and the vascular anatomy is very consistent.