中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2015年
4期
350-353
,共4页
简超%陶圣祥%谭金海%余国荣%喻爱喜
簡超%陶聖祥%譚金海%餘國榮%喻愛喜
간초%도골상%담금해%여국영%유애희
胸肩峰动脉胸肌支%胸大肌肌腱%气管缺损%移位%修复
胸肩峰動脈胸肌支%胸大肌肌腱%氣管缺損%移位%脩複
흉견봉동맥흉기지%흉대기기건%기관결손%이위%수복
Thoracoacromial pectoral artery branches%Pectoralis major tendon%Tracheal defects%Transposition%Repair
目的 解剖观察为带蒂胸大肌肌腱瓣移位修复颈部气管壁缺损的可行性,初步探讨其临床疗效. 方法 在32侧成人侧胸部标本上测量胸大肌肌腱长、宽、厚,观察胸肩峰动脉及胸肌支起点、分布情况,测量以胸肩峰动脉胸肌支为蒂的胸大肌肌腱瓣的血管神经蒂长度、旋转半径及其与气管受区的距离;并在尸体上摹拟手术.临床应用以胸肩峰动脉胸肌支为蒂的胸大肌肌腱瓣移位修复颈部气管前壁3.0 cm×1.5 cm缺损并切口感染患者1例,术后随访其疗效. 结果 胸大肌肌腱长(22.9±0.9)mm、宽(51.0±2.4)mm、厚(5.81±1.35) mm.以胸肩峰动脉胸肌支为蒂的胸大肌肌腱瓣血管蒂长度为(89.3±5.3) mm,旋转半径为(121.7±8.2)mm,其旋转点至受区中心距离为(96.5±8.9)mm.术后随访患者5个月,患者颈部外形良好,无气肿,发音正常.术后3个月颈部CT扫描示气管修复区管腔前后径2.6 cm,左右径1.8 cm,管腔无明显狭窄. 结论 以胸肩峰动脉胸肌支为蒂的胸大肌肌腱瓣移位可有效修复颈部气管壁缺损.
目的 解剖觀察為帶蒂胸大肌肌腱瓣移位脩複頸部氣管壁缺損的可行性,初步探討其臨床療效. 方法 在32側成人側胸部標本上測量胸大肌肌腱長、寬、厚,觀察胸肩峰動脈及胸肌支起點、分佈情況,測量以胸肩峰動脈胸肌支為蒂的胸大肌肌腱瓣的血管神經蒂長度、鏇轉半徑及其與氣管受區的距離;併在尸體上摹擬手術.臨床應用以胸肩峰動脈胸肌支為蒂的胸大肌肌腱瓣移位脩複頸部氣管前壁3.0 cm×1.5 cm缺損併切口感染患者1例,術後隨訪其療效. 結果 胸大肌肌腱長(22.9±0.9)mm、寬(51.0±2.4)mm、厚(5.81±1.35) mm.以胸肩峰動脈胸肌支為蒂的胸大肌肌腱瓣血管蒂長度為(89.3±5.3) mm,鏇轉半徑為(121.7±8.2)mm,其鏇轉點至受區中心距離為(96.5±8.9)mm.術後隨訪患者5箇月,患者頸部外形良好,無氣腫,髮音正常.術後3箇月頸部CT掃描示氣管脩複區管腔前後徑2.6 cm,左右徑1.8 cm,管腔無明顯狹窄. 結論 以胸肩峰動脈胸肌支為蒂的胸大肌肌腱瓣移位可有效脩複頸部氣管壁缺損.
목적 해부관찰위대체흉대기기건판이위수복경부기관벽결손적가행성,초보탐토기림상료효. 방법 재32측성인측흉부표본상측량흉대기기건장、관、후,관찰흉견봉동맥급흉기지기점、분포정황,측량이흉견봉동맥흉기지위체적흉대기기건판적혈관신경체장도、선전반경급기여기관수구적거리;병재시체상모의수술.림상응용이흉견봉동맥흉기지위체적흉대기기건판이위수복경부기관전벽3.0 cm×1.5 cm결손병절구감염환자1례,술후수방기료효. 결과 흉대기기건장(22.9±0.9)mm、관(51.0±2.4)mm、후(5.81±1.35) mm.이흉견봉동맥흉기지위체적흉대기기건판혈관체장도위(89.3±5.3) mm,선전반경위(121.7±8.2)mm,기선전점지수구중심거리위(96.5±8.9)mm.술후수방환자5개월,환자경부외형량호,무기종,발음정상.술후3개월경부CT소묘시기관수복구관강전후경2.6 cm,좌우경1.8 cm,관강무명현협착. 결론 이흉견봉동맥흉기지위체적흉대기기건판이위가유효수복경부기관벽결손.
Objective To provide an anatomical basis for repairing the defect of cervical tracheal wall with vascularized pectoralis major tendon flaps.Methods Thirty-two lateral thoracic necrotomies were studied for the following aspects.Measurement of pectoralis major tendons' length,width and thickness.Anatomy of thoracoacromialartery,pectoral branches:origin,distribution.Measurement of length of pedicle,rotated radius of flaps and length from recipient site.An imitative operation was undergone on a specimen of corpse.One patient was undergone the operation of repairing the 3.0 cm × 1.5 cm defect of anterior cervical trachea wall,accompanying with incision infection,with pectoralis major tendon flap.Results Length of pectoralis major tendon:(22.9 ± 0.9)mm.Width of tendon:(51.0± 2.4)mm.Thickness of tendon:(5.81± 1.35)mm.Length of pedicle:(89.3 ± 5.3) mm.The radius of pedicle pectoralis major myotendinous flap:(121.7± 8.2)mm.The distance from pivot point of flap to central point of recipient:(96.5 ± 8.9)mm.Patient possessed normal pronunciation,good appearance and no emphysema at 5 months' follow-up.Tracheal lumen,measured 2.6 cm in the anteroposterior dimension and 1.8 cm in the lateral dimension,showed no recurrence of obvious stenosis in cervical computed tomography at 3 month postoperatively.Conclusion Pedicle pectoralis major tendon flaps,originated from thoracoacromial artery pectoral branches can repair cervical tracheal wall defects effectively.
