应用超声血流探测实施腓肠肌神经营养皮瓣修复小腿下段皮肤<br />软组织缺损<br />-《中国美容医学》

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Title:: Repair of Skin and Soft Tissue Defects of Lower Leg Using Gastrocnemius Nerve
Nutirent Flap by Ultrasonic Blood Flow Detection

文章编号:: 1008-6455（2020）11-0027-03

作者:: 张波; 赵阳

Author(s):: ZHANG Bo; ZHAO Yang

关键词:: [关键词]皮肤软组织缺损; 小腿下段; 腓肠肌神经营养皮瓣; 缺损修复; 超声血流探测

Keywords:: Key words: skin and soft tissue defect; lower leg; gastrocnemius nerve nutrition flap; defect repair; ultrasonic blood flowdetection

分类号:: R622

文献标志码:: A

摘要:: [摘要]目的：分析应用超声血流探测实施腓肠肌神经营养皮瓣修复小腿下段皮肤软组织缺损的临床效果。方法：回顾性分
析笔者医院2014年1月-2015年1月，收治的30例小腿下段皮肤软组织缺损患者为研究对象，均应用超声血流探测实施腓肠
肌神经营养皮瓣修复，并在显微镜的介导下，吻合腓肠肌神经近端与小腿部缺损创面处的胫神经，吻合小隐静脉与大隐静
脉。分析本组患者的临床效果，随访2年，进一步分析患者的预后。结果：本组30例患者均顺利完成手术，术前超声血流
探测，腓肠肌神经营养皮瓣的穿支动脉内径为(0.89±0.25)mm，收缩期峰值流速为(0.19±0.07)m/s，皮瓣筋膜蒂长度为
(8.40±3.29)cm，术后创面均一期愈合，随访2年，修复创面的皮瓣均恢复良好，下肢活动功能恢复满意。随访期间，患者
修复皮瓣感觉良好，显著恢复皮肤感觉，两点辨别觉最小10mm，最大15mm，平均(11.2±0.25)mm。结论：应用超声血流探测
进行腓肠肌神经营养皮瓣设计，可覆盖小腿下段皮肤软组织缺损，重建感觉功能，且皮瓣存活率高、预后良好，可作为修复
小腿下段皮肤软组织缺损的理想选择。

Abstract:: Abstract: Objective To analyze the clinical effect of using gastrocnemius nerve nutirent flap to repair skin and soft tissue
defects of the lower leg. Methods Retrospective analysis of our patients from January 2014 to January 2015,30 cases of
treatment for skin and soft tissue defects of the lower leg. Under the guidance of microscope, the proximal end of gastrocnemius
nerve was anastomosed with the tibial nerve at the defect of leg, and the saphenous vein and great saphenous vein were
anastomosed. Analysis of the clinical effect of this group of patients, followed up for 2 years, further analysis of the prognosis
of patients. Results 30 patients were successfully completed the surgical operations, ultrasonic blood fl ow detection before
operations,inner diameter of perforating artery of gastrocnemius neurotrophic fl ap was (0.89±0.25)mm, peak systolic blood fl ow
velocity was (0.19±0.07)m/s, length of fl ap fascial pedicle was (8.40±3.29)cm, all the wounds were healed at one stage after
operation,followed-up for 2 years,the fl aps recovered well and the lower limb movement function recovered satisfactorily,during
the follow-up period,the skin sensation was signifi cantly restored, with two point discrimination of minimum 10 mm, maximum
15 mm, average (11.2±0.25)mm. Conclusion The design of gastrocnemius nerve nutrition flap with ultrasonic blood flow
detection can cover the skin and soft tissue defects of the lower leg, reconstruct the sensory function, and the fl ap has high
survival rate and good prognosis, which can be used as an ideal choice to repair the skin and soft tissue defects of the lower leg.

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

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