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目的为旋髂深动脉穿支骨皮瓣的设计与安全截取提供解剖学基础。方法选6具未经固定处理的尸体,采用改良明胶/氧化铅灌注技术进行动脉灌注,层次解剖观测腰区外径≥0.5 mm的穿支,测量其管径及其走行、分支、分布情况并拍摄X线片。利用Photoshop与Scion Image软件分析穿支供血的趋向性及每个分支的供血面积等。另选1具未固定处理的男尸,采用羧甲基纤维素/氧化铅水凝胶行一次性全身动脉造影,并进行CT扫描与三维重建。结果旋髂深动脉穿支(DCIAP)的出现率为92%,平均每侧为1.6支,直径0.7mm,其穿支出现于髂前上棘后方5~10cm,髂嵴上方12~35mm之间,供血范围为31 cm2。结论旋髂深动脉起源、行程及其穿支较恒定,具备穿支骨皮瓣的解剖学基础,可截取穿支皮瓣(肌皮瓣或骨皮瓣)进行游离移植或转位,用于复合组织缺损的重建。
Objective To provide an anatomical basis for the design and safety interception of the deep iliac artery perforating branch bone flap. Methods Six non-fixed cadavers were selected. Arterial perfusion was performed using modified gelatin / lead oxide perfusion technique. The perforating branches with the diameter of 0.5 mm or more in the lumbar region were observed by the level anatomy. The diameter, the branch, the distribution were measured. X-ray filming. Using Photoshop and Scion Image software to analyze the trend of perfused blood supply and each branch of the blood supply area. Another non-fixed male corpse, using carboxymethyl cellulose / lead oxide hydrogel disposable systemic arteriography, and CT scan and three-dimensional reconstruction. Results The incidence of deep iliac artery perforating branches (DCIAP) was 92%, with an average of 1.6 on each side and a diameter of 0.7 mm. The perforating branches appeared in 5 ~ 10 cm behind the anterior superior iliac spine and 12 ~ 35 mm above the iliac crest , Blood supply range of 31 cm2. Conclusions The origin, stroke and perforating branch of the ilium iliac artery are relatively constant. They have the anatomic basis of perforation of the peroneal bone flap, and the perforator flap (myocutaneous flaps or bone flaps) can be intercepted for free graft or transposition for Reconstruction of composite tissue defects.