彩色多普勒超声成像技术与CT血管造影在足趾移植再造拇指中的临床应用
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摘要
目的探讨彩色多普勒超声成像技术与CT血管造影(CTA)在足趾移植再造拇指中的临床应用价值。方法选取2017年1月至2018年10月辽宁省抚顺市中医院收治的28例拇指缺损患者,予以回顾性分析,患者均给予足趾移植再造术,术前给予CTA以及彩色多普勒超声成像技术检查,定位供区血管的走行以及毗邻情况,检测供区足部第一跖背动脉起始内径大小、距皮肤的距离,同时量化与标测供区血管的起始内径。结果经CTA与彩色多普勒超声检测,28例患者的足部第一跖背动脉均可以清晰显现,术前CTA与彩色多普勒超声检测所得的供血血管充盈状况、走行均与术中情况相符,CTA、彩色多普勒超声以及术中测量的第一跖背动脉起始内径比较,差异均具有统计学意义(P <0. 05),而相距皮肤的距离三者比较,差异均无统计学意义(P> 0. 05)。术后28例患者再造拇指体均成活。结论彩色多普勒超声成像技术与CTA结合运用于足趾移植再造拇指的术前检查,可以较好地反映出足部供区血管的解剖情况,为临床提供清晰的血供图像,对于临床相关研究有极高价值。
Objective To explore the clinical significance of color Doppler ultrasound imaging and CT angiography( CTA) in reconstruction of thumb and fingers after toe transplantation. Methods The clinical data of twenty-eight patients with thumb defects admitted to tthis hospital during January 2017 to October 2018 were retrospectively analyzed. All these patients were given with toe reconstruction and preoperative CTA and color Doppler ultrasound imaging. To check and locate the blood vessels in donor site and the adjacent conditions,the initial inner diameter of dorsal artery in donor site and the distance from skin,and to quantify and mark the initial diameter of blood supply in the donor site. Results After CTA and color Doppler ultrasonic detection,28 patients with foot back first plantar artery can be clearly revealed preoperative CTA with color Doppler ultrasonic detection of the blood vessels supplying and filling status,directions are consistent with intraoperative situation,CTA,color Doppler ultrasonography and intraoperative measurement of first plantar in comparison with the diameter of dorsal artery,the difference was statistically significant( P < 0. 05),and to compare with the distance away from skin,there was no statistically significant difference( P > 0. 05).Twenty-eight patients with thumb and finger reconstruction were survived after the operation. Conclusion Color Doppler ultrasound imaging combined with CTA in the preoperative examination of thumb and finger reconstruction after toe transplantation can better reflect the anatomical situation of blood vessels in foot supply area and provide a clear blood supply image for clinical application,which is of great importance for clinical application.
Objective To explore the clinical significance of color Doppler ultrasound imaging and CT angiography( CTA) in reconstruction of thumb and fingers after toe transplantation. Methods The clinical data of twenty-eight patients with thumb defects admitted to tthis hospital during January 2017 to October 2018 were retrospectively analyzed. All these patients were given with toe reconstruction and preoperative CTA and color Doppler ultrasound imaging. To check and locate the blood vessels in donor site and the adjacent conditions,the initial inner diameter of dorsal artery in donor site and the distance from skin,and to quantify and mark the initial diameter of blood supply in the donor site. Results After CTA and color Doppler ultrasonic detection,28 patients with foot back first plantar artery can be clearly revealed preoperative CTA with color Doppler ultrasonic detection of the blood vessels supplying and filling status,directions are consistent with intraoperative situation,CTA,color Doppler ultrasonography and intraoperative measurement of first plantar in comparison with the diameter of dorsal artery,the difference was statistically significant( P < 0. 05),and to compare with the distance away from skin,there was no statistically significant difference( P > 0. 05).Twenty-eight patients with thumb and finger reconstruction were survived after the operation. Conclusion Color Doppler ultrasound imaging combined with CTA in the preoperative examination of thumb and finger reconstruction after toe transplantation can better reflect the anatomical situation of blood vessels in foot supply area and provide a clear blood supply image for clinical application,which is of great importance for clinical application.
引文
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[11]赵芝弘,翟玉霞.正常成人食指桡侧动脉的彩色多普勒超声血流动力学研究[J].汕头大学医学院学报,2017,30(2):119-120.
[12]张荐,刘德群,张宇新.彩色多普勒在穿支皮瓣的临床应用及研究进展[J].中国煤炭工业医学杂志,2015,18(6):1060-1064.
[13]段家章,何晓清,徐永清,等.数字化技术在股前外侧皮瓣修复手足创面中的应用[J].中国修复重建外科杂志,2015,29(7):807-811.
[14]方早,金淑芳,田卓炜,等. CT血管造影在腓肠内侧动脉穿支皮瓣血管定位中的应用[J].中国口腔颌面外科杂志,2015,13(3):220-225.
[15]卿黎明,胡懿郃,唐举玉,等.基于数字化技术的腓肠内侧动脉穿支皮瓣血供的三维可视化重建研究[J].中国修复重建外科杂志,2014,28(6):697-700.
[2]侍朋举,张文龙,赵刚,等.足背皮瓣串并联甲复合组织瓣修复手部脱套伤伴拇指缺损[J].中国修复重建外科杂志,2015,29(7):799-803.
[3]孙鹏,战杰,石强,等.带甲下趾骨甲皮瓣游离移植修复拇指皮肤套脱伤[J].实用手外科杂志,2015,29(1):78-80.
[4]彭晓旭.部分趾骨的游离甲瓣移植治疗拇指脱套伤后患者拇指功能恢复情况分析[J].临床医学工程,2016,23(3):329-330.
[5]陈艳丽.足趾甲皮瓣游离移植再造拇指末节围手术期的护理体会[J].中国冶金工业医学杂志,2018,35(3):299-300.
[6]林志雄,耿成龙.尺背侧皮神经营养血管皮瓣和邻指皮瓣修复拇指指端缺损的疗效比较[J].临床和实验医学杂志,2015,14(17):1460-1463.
[7]莫勇军,谭海涛,韦平欧,等.数字化技术辅助多手指缺损再造的应用价值[J].中华显微外科杂志,2014,37(4):338-343.
[8] Feng S,Xi W,Zhang Z,et al. A reappraisal of the surgical planning of the superficial circumflex iliac artery perforator flap[J]. J Plast Reconstr Aesthet Surg,2017,70(4):469-477.
[9]赵新宇,王俊青,鄂占森.拇长屈肌毗邻解剖结构的高频超声研究[J].中国医学影像学杂志,2014,22(5):350-353.
[10]陈山林,杨德金.数字医学-显微外科发展的机遇[J].中华显微外科杂志,2014,37(4):313-315.
[11]赵芝弘,翟玉霞.正常成人食指桡侧动脉的彩色多普勒超声血流动力学研究[J].汕头大学医学院学报,2017,30(2):119-120.
[12]张荐,刘德群,张宇新.彩色多普勒在穿支皮瓣的临床应用及研究进展[J].中国煤炭工业医学杂志,2015,18(6):1060-1064.
[13]段家章,何晓清,徐永清,等.数字化技术在股前外侧皮瓣修复手足创面中的应用[J].中国修复重建外科杂志,2015,29(7):807-811.
[14]方早,金淑芳,田卓炜,等. CT血管造影在腓肠内侧动脉穿支皮瓣血管定位中的应用[J].中国口腔颌面外科杂志,2015,13(3):220-225.
[15]卿黎明,胡懿郃,唐举玉,等.基于数字化技术的腓肠内侧动脉穿支皮瓣血供的三维可视化重建研究[J].中国修复重建外科杂志,2014,28(6):697-700.
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