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目的应用CT血管成像(CTA)观察腹壁下动脉穿支皮瓣修复上肢电击伤后的皮瓣血运。方法 6例高压电击伤患者上肢损伤后实施腹壁皮瓣修复术,采用CTA行上肢及腹壁血管造影,评价皮瓣修复后上肢血管和腹壁下动脉深穿支的血管分支显示。结果 MSCTA能够良好地显示上肢血管和腹壁下动脉及其分支;其中4例显示为优良,2例欠佳;显示优良患者均能准确评价较粗大穿支血管的起源、皮下和肌肉内的走行,同时精确定位选择的穿支血管穿出腹直肌筋膜的位置;较好地显示穿支血管与上肢皮瓣内血运。结论 CTA是一种有效地评价皮瓣修复术后皮瓣血运的方法,可评判皮瓣修复术成败。
Objective To observe the blood transfusion of flaps of upper extremity after electric shock injury by CT angiography (CTA). Methods Six cases of high-voltage electric injury were treated with abdominal skin flap repair after upper limb injury. Upper limbs and abdominal wall angiography were performed by CTA to evaluate the vascular branches of the upper extremity and deep abdominal perforators after skin flap repair. Results MSCTA could display the superior arteries and the inferior arteries and their branches well. Among them, 4 cases showed excellent and 2 cases poor, which showed that the excellent patients were able to accurately evaluate the origin, subcutaneous and intramuscular migration of the larger perfused blood vessels, While pinpointing the location of the selected perforating branch piercing the rectus abdominis; the blood flow through the perforating and upper limbal flaps is better shown. Conclusion CTA is an effective method to evaluate flap blood flow after skin flap repair, and it can judge the success or failure of skin flap repair.