术前血管定位技术在穿支皮瓣中的应用进展

doi:10.7518/hxkq.2017.06.018

华西口腔医学杂志 ›› 2017, Vol. 35 ›› Issue (6): 659-662.doi: 10.7518/hxkq.2017.06.018

术前血管定位技术在穿支皮瓣中的应用进展

吴连俊^1,², 王慧明²()

1.温州医科大学口腔医学院附属口腔医院种植科,温州 325027
2.浙江大学医学院附属第一医院口腔颌面外科,杭州 310006

收稿日期:2017-02-05 修回日期:2017-06-24 出版日期:2017-12-20 发布日期:2017-12-01
作者简介:
吴连俊,硕士,E-mail:657453407@qq.com
基金资助:
国家自然科学基金（30900300）

Application of preoperative vascular localization techniques for perforator flaps

Lianjun Wu^1,², Huiming Wang²()

1. Dept. of Implantation, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China
2. Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou 310006, China

Received:2017-02-05 Revised:2017-06-24 Online:2017-12-20 Published:2017-12-01
Supported by:
Supported by: The National Natural Science Foundation of China (30900300).

摘要/Abstract

摘要：

随着显微血管技术的发展,穿支皮瓣逐渐成为组织缺损重建的首选方法之一。穿支皮瓣供血血管管径细、血管蒂长、血管走行及位置变异大,这就需要临床医生采用术前血管定位技术对穿支血管的解剖结构进行系统评估,从而设计合适的穿支皮瓣。本文就穿支皮瓣的特点及种类,术前定位技术在穿支皮瓣中的研究进展及存在的主要问题作一综述。

关键词: 穿支皮瓣, 术前血管定位技术, 多普勒超声, 计算机断层扫描血管造影, 磁共振血管造影

Abstract:

With the development of microvascular technology, perforator flaps have gradually become a good alternative for reconstruction of tissue defects. However, the major limitations of perforator flaps include uncertainty in predicting ana-tomical location of perforators and high variability in perforator size and course, which require preoperative localization tech-niques. Recently, as one of the preoperative localization techniques, computed tomography angiography was used to determine the number, size, course, and exact emerging point of perforator flaps. Clinicians can reduce surgical complications and shorten operative time by using computed tomography angiography. However, only several studies reported clinical applications of computed tomography angiography. This article reviews characteristics, classification, and preoperative location techniques for perforator flaps and its problems.

Key words: perforator flap, preoperative vascular localization technique, Doppler ultrasound, computed tomography angiography, magnetic resonance angiography

中图分类号:

R782.2

吴连俊, 王慧明. 术前血管定位技术在穿支皮瓣中的应用进展[J]. 华西口腔医学杂志, 2017, 35(6): 659-662.

Lianjun Wu, Huiming Wang. Application of preoperative vascular localization techniques for perforator flaps[J]. West China Journal of Stomatology, 2017, 35(6): 659-662.

参考文献 21

[1]	Kroll SS, Rosenfield L.Perforator-based flaps for low pos-terior midline defects[J]. Plast Reconstr Surg, 1988, 81(4):561-566.
[2]	Koshima I, Soeda S.Inferior epigastric artery skin flaps without rectus abdominis muscle[J]. Br J Plast Surg, 1989, 42(6):645-648.
[3]	Cho A, Hall FT.Review of perforator flaps in head and neck cancer surgery[J]. Curr Opin Otolaryngol Head Neck Surg, 2016, 24(5):440-446.
[4]	邓娜, 何巍, 李锐, 等. 股前外侧穿支皮瓣修复口腔癌术后缺损患者的生活质量评估[J]. 华西口腔医学杂志, 2015, 33(2):197-200.
	Deng N, He W, Li R, et al.Assessment of the quality of life of oral cancer patients after reconstruction with free antero-lateral thigh perforator flaps[J]. West Chin J Stomatol, 2015, 33(2):197-200.
[5]	Koshima I, Fukuda H, Yamamoto H, et al.Free anterolateral thigh flaps for reconstruction of head and neck defects[J]. Plast Reconstr Surg, 1993, 92(3):421-428.
[6]	Cavadas PC, Sanz-Giménez-Rico JR, Gutierrez-de la Cámara A, et al. The medial sural artery perforator free flap[J]. Plast Reconstr Surg, 2001, 108(6):1609-1615.
[7]	Ribuffo D, Atzeni M, Saba L, et al.Clinical study of pero-neal artery perforators with computed tomographic angio-graphy: implications for fibular flap harvest[J]. Surg Radiol Anat, 2009, 32(4):329-334.
[8]	Kimata Y, Uchiyama K, Ebihara S, et al.Anatomic varia-tions and technical problems of the anterolateral thigh flap: a report of 74 cases[J]. Plast Reconstr Surg, 1998, 102(5):1517-1523.
[9]	Chen SY, Lin WC, Deng SC, et al.Assessment of the per-forators of anterolateral thigh flaps using 64-section multi-detector computed tomographic angiography in head and neck cancer reconstruction[J]. Eur J Surg Oncol, 2010, 36(10):1004-1011.
[10]	Isken T, Alagoz MS, Onyedi M, et al.Preoperative color Doppler assessment in planning of gluteal perforator flaps[J]. Ann Plast Surg, 2009, 62(2):158-163.
[11]	Okamoto H, Sekiya I, Mizutani J, et al.Anatomical basis of the medial sural artery perforator flap in Asians[J]. Scand J Plast Reconstr Surg Hand Surg, 2007, 41(3):125-129.
[12]	Pratt GF, Rozen WM, Chubb D, et al.Preoperative imaging for perforator flaps in reconstructive surgery: a systematic review of the evidence for current techniques[J]. Ann Plast Surg, 2012, 69(1):3-9.
[13]	Yu P, Youssef A.Efficacy of the handheld Doppler in preo-perative identification of the cutaneous perforators in the anterolateral thigh flap[J]. Plast Reconstr Surg, 2006, 118(4):928-933.
[14]	Seidenstucker K, Munder B, Richrath P, et al. A prospective study using color flow duplex ultrasonography for abdominal perforator mapping in microvascular breast reconstruction[J]. Med Sci Monit, 2010, 16(8):MT65-MT70.
[15]	Klasson S, Svensson H, Malm K, et al.Preoperative CT an-giography versus Doppler ultrasound mapping of abdominal perforator in DIEP breast reconstructions: a randomized prospective study[J]. J Plast Reconstr Aesthet Surg, 2015, 68(6):782-786.
[16]	Cina A, Salgarello M, Barone-Adesi L, et al.Planning breast reconstruction with deep inferior epigastric artery perfo-rating vessels: multidetector CT angiography versus color Doppler US[J]. Radiology, 2010, 255(3):979-987.
[17]	Newman TM, Vasile J, Levine JL, et al.Perforator flap mag-netic resonance angiography for reconstructive breast sur-gery: a review of 25 deep inferior epigastric and gluteal per-forator artery flap patients[J]. J Magn Reson Imaging, 2010, 31(5):1176-1184.
[18]	Liu SC, Chiu WK, Chen SY, et al.Comparision of surgical result of anterolateral thigh flap in reconstruction of through-and-through cheek defect with/without CT angiography guidance[J]. J Craniomaxillofac Surg, 2011, 39(8):633-638.
[19]	Yang JF, Wang BY, Zhao ZH, et al.Clinical applications of preoperative perforator planning using CT angiography in the anterolateral thigh perforator flap transplantation[J]. Clin Radiol, 2013, 68(6):568-573.
[20]	Feng S, Min P, Grassetti L, et al.A prospective head-to-head comparison of color Doppler ultrasound and computed tomographic angiography in the preoperative planning of lower extremity perforator flaps[J]. Plast Reconstr Surg, 2016, 137(1):335-347.
[21]	Rozen WM, Chubb D, Crossett M, et al.The future in per-forator flap imaging: a new technique to substantially reduce radiation dose with computed tomographic angiography[J]. Plast Reconstr Surg, 2010, 126(2):98e-100e.

术前血管定位技术在穿支皮瓣中的应用进展

Application of preoperative vascular localization techniques for perforator flaps

RichHTML

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献 21

相关文章 1

编辑推荐

Metrics

本文评价