腋窝真皮下血管网构筑解剖学基础.docVIP

腋窝真皮下血管网构筑解剖学基础[摘要]目的：研究腋窝真皮下血管网构筑的解剖学基础和临床意义。方法：16侧经肱动脉灌注红色乳胶液、常规福尔马林固定的尸体解剖并6例上肢血管铸型标本，解剖观测真皮下层的动静脉网结构 以及血管来源、分布和 吻合情况。结果：真皮下血管网位于真皮网状层和皮下组织交界处。若保留真皮下血管网完整而不受损伤，则需保留真皮下脂肪2～3mm。构成此血管网的分支多是各皮动脉较粗分支或主干终末支，口径较粗( 直径0.3～0.5mm)，多向浅面发出，垂直或斜穿少量浅筋膜很快进入真皮下层构成吻合稠密的真皮下血管网。腋中线和腋后线附近的真皮下血管网吻合稠密程度高于腋前线附近的吻合稠密程度。结论：腋窝真皮下血管网构筑的特点是临床应用的基础。 [关键词]腋窝；真皮下血管网；皮瓣；应用解剖 [中图分类号]R322[文献标识码]A[文章编号]1008-6455（2011）03-0428-03 Anatomic basis of the subdermal vascular network in axillary fossa WANG Qing,LIU Da-lie,WANG Jin-huang,CHEN Bing,CHEN Bo-hua （Department of Plastic and Cosmetic Surgery，Zhujiang Hospital,Southem Medical University,Guangzhou 510282,Guangdong,China） Abstract:ObjectiveTo investigate the anatomic basis and clinical signifance of subdermal vascular network(SVN) in axillary fossa. Methods 16sides of adult upper fresh specimens were perfused red emulsion into brachial artery,the distribution of blood vessels of subdermal vascular network in axillary fossa was anatomically observed．And vascular distribution in axillary fossa was examed on 6 cases cast specimens.ResultsSubdermal vascular networks formed between the dermal reticular layer and superficial fascia,were orignited from the cutaneous arteries through axillary deep fascia ,which appeared as the shape of tree branches . Fat tissue under dermis should be retained vertically about 2～3 mm in order to protect the subdermal vascular network(SVN) in axillary fossa.The density of subdermal vascular network (SVN) varied from place to place.ConclusionThe characteristics of subdermal vascular network in axillary fossa play important role in the clinic application. Key words:axillary fossa;subdermal vascular network;flap;applied anatomy 腋窝以腋皱襞为界，可分为臂内侧区域和侧胸区域两部分，是真皮下血管网(Subdermal VascularNetwork, SVN)皮片[1]、真皮下血管网皮瓣[2]的常用供区；同时也是临床上一个重要且常用的手术区域。在腋窝入路隆乳、乳癌根治、腔镜腋窝淋巴结清扫、副乳切除、腋臭根治、腋部瘢痕挛缩整复等诸多手术中，保护腋窝皮肤血供是防治术后皮肤坏死的重要环节。因此，掌握腋窝真皮下血管网构筑的解剖学基础，对临床应用十分重要。然而，目前尚无腋窝真皮下血管网构筑的解剖学研究报导。为此，我们对腋窝真皮下血管网构筑的动脉血供及静脉回流情况进行解剖学基础研究，为临床应用提