CAJ | 학술논문

目的应用CT血管造影(computed tomography angiography,CTA)研究腹壁下动脉穿支皮瓣(DIEP)的静脉血管构造,并探讨腹壁静脉系统在DIEP皮瓣修薄中的应用.方法 2012年2月至2014年8月,对11例拟行修薄DIEP皮瓣手术的患者,术前行腹壁静脉血管CTA检查,研究腹壁下静脉、腹壁浅静脉以及静脉穿支的走行、分支及相互吻合情况,并根据腹壁静脉血管构造进行DIEP皮瓣的修薄.结果共观测22条腹壁下静脉、22条腹壁浅静脉及22条每侧最粗的穿支静脉的CTA图像.在脐上3 cm至脐下15 cm区域,腹壁浅静脉与腹壁中线距离为3.30～5.77 cm,走行深度比例为0.29 ～0.39.腹壁浅静脉是腹壁浅层的主要回流静脉,与腹壁下静脉以穿支静脉形式在脐周存在吻合.根据腹壁浅静脉的走行及层次进行DIEP皮瓣修薄的11例患者,术后皮瓣均无静脉回流障碍.结论术前腹壁静脉CTA图像能清晰地显示DIEP皮瓣的静脉血管构造,腹壁浅静脉可作为指导DIEP皮瓣修薄的标志性参考解剖结构.
목적 응용CT혈관조영(computed tomography angiography,CTA)연구복벽하동맥천지피판(DIEP)적정맥혈관구조,병탐토복벽정맥계통재DIEP피판수박중적응용.방법 2012년2월지2014년8월,대11례의행수박DIEP피판수술적환자,술전행복벽정맥혈관CTA검사,연구복벽하정맥、복벽천정맥이급정맥천지적주행、분지급상호문합정황,병근거복벽정맥혈관구조진행DIEP피판적수박.결과 공관측22조복벽하정맥、22조복벽천정맥급22조매측최조적천지정맥적CTA도상.재제상3 cm지제하15 cm구역,복벽천정맥여복벽중선거리위3.30～5.77 cm,주행심도비례위0.29 ～0.39.복벽천정맥시복벽천층적주요회류정맥,여복벽하정맥이천지정맥형식재제주존재문합.근거복벽천정맥적주행급층차진행DIEP피판수박적11례환자,술후피판균무정맥회류장애.결론 술전복벽정맥CTA도상능청석지현시DIEP피판적정맥혈관구조,복벽천정맥가작위지도DIEP피판수박적표지성삼고해부결구.
Objective To explore the venous angio-architecture of deep inferior epigastric artery perforator (DIEP) flap with computed tomography angiography(CTA) and the application of venous angioarchitecture in flap thinning of DIEP flap.Methods From February 2012 to August 2014,preoperative CTA examination of venous system of DIEP flap was performed in 11 patients to study the course,the branch and the anastomosis of the deep inferior epigastric veins,the superficial inferior epigastric veins and the perforator veins.The flap thinning of DIEP flap was based on the finding of the abdominal venous system.Results The CTA images were obtained including 22 deep inferior epigastric veins,22 superficial inferior epigastric veins and 22 perforator veins.The distance between the superficial inferior epigastric vein and abdominal midline was 3.30 cm to 5.77 cm in the zone 3 cm above umbilicus and in the zone 15 cm below umbilicus.The superficial inferior epigastric vein was 0.29 to 0.39 in depth ratio.The superficial inferior epigastric veins were the main drainage vessels of superficial abdominal wall according to the CTA images.They were anastomosed with the deep inferior epigastric veins through perforator veins.The 11 DIEP flaps were thinned based on the structure of the superficial inferior epigastric veins and all flaps had no drainage disturbance.Conclusions Preoperative CTA images can display the venous angio-architecture of deep inferior epigastric artery perforator flap.The superficial inferior epigastric vein can be utilized as reference architecture to guide flap thinning of DIEP flap.