CAJ | 학술논문

目的探讨颈肩峰区跨区供血轴型皮瓣的解剖学基础及临床应用可行性.方法在北京协和医学院基础研究所解剖形态实验室提供的5具(10侧)新鲜成人尸体及10具(20侧)防腐成人标本上,应用医用红色乳胶灌注动脉,蓝色乳胶灌注静脉,在直视或手术显微镜下,解剖颈肩峰区动静脉、皮动脉以及真皮下血管网、深筋膜浅层血管网,对前界为锁骨、后界为肩胛冈、外侧界为肩峰、内侧为颈根部的颈肩峰区主要血供进行巨微解剖学观察.结果 ①皮动脉穿出点集中在斜方肌前缘及其延伸线的区域,宽度约4 cm的范围；②斜方肌前缘及其延伸线为轴心的中间部位,吻合支最为丰富,血管吻合多为网状,其次是肩胛冈上区.在众多的吻合支中可观察到每侧颈肩峰区均有2～3支明显的贯穿颈根至肩峰全长的吻合支,多位于中轴位置及后侧,在深筋膜浅层至真皮下血管网之间有丰富的交通支相连.结论颈肩峰区皮动脉穿出点位置恒定,深筋膜浅层血管吻合支丰富,可形成颈肩峰区跨区供血轴型皮瓣.
목적 탐토경견봉구과구공혈축형피판적해부학기출급림상응용가행성.방법 재북경협화의학원기출연구소해부형태실험실제공적5구(10측)신선성인시체급10구(20측)방부성인표본상,응용의용홍색유효관주동맥,람색유효관주정맥,재직시혹수술현미경하,해부경견봉구동정맥、피동맥이급진피하혈관망、심근막천층혈관망,대전계위쇄골、후계위견갑강、외측계위견봉、내측위경근부적경견봉구주요혈공진행거미해부학관찰.결과 ①피동맥천출점집중재사방기전연급기연신선적구역,관도약4 cm적범위；②사방기전연급기연신선위축심적중간부위,문합지최위봉부,혈관문합다위망상,기차시견갑강상구.재음다적문합지중가관찰도매측경견봉구균유2～3지명현적관천경근지견봉전장적문합지,다위우중축위치급후측,재심근막천층지진피하혈관망지간유봉부적교통지상련.결론 경견봉구피동맥천출점위치항정,심근막천층혈관문합지봉부,가형성경견봉구과구공혈축형피판.
Objective To investigate the applied anatomy of the blood supply of the cervicoacromial crossing flap and its feasibility in clinical application.Methods 5 fresh adult and 10 forman fixed adult cadaver specimens were used.The arteries,veins,cutaneous arteries,subdermal vascular network,and vascular network of the superficial layer of deep fascia in the cervico-acromial area were observed and studied under the microscope.The frontier border of the cervico-acromial area is clavicle,the posterior border is the spine of scapula,the outer border is acromion and the inner border is cervical base.Results ① The perforator branches concentrate at the front edge of trapezius muscle; ②The vessel network around the front edge of trapezius muscle is abundant.Among the anastomosis,two or three anastomosis which across the area from the base of the neck to acromion can be observed in the axial of every cervico-acromial area.Abundant vessel network can be observed in the superficial layer of deep fascia.Conclusions The boold supply of the cervico-acromial flap is abundant,which constains constant perforator point.The cervico-acromial crossing skin flap can be applied with the rich blood supply and abundant vessel network in the superficial layer of deep fascia.