带血管股骨复合组织瓣重建半骨盆截肢术后骨与软组织缺损的解剖学分析

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1、摘要3)带血管股骨复合组织瓣设计的复合组织瓣以股动脉和股深动脉及其伴行静脉作为吻合血管。复合组织瓣平均面积为(1007___58)am2，远大于半骨盆截肢术后的软组织缺损面积(697±34)cm2；墨染试验结果显示整个复合组织瓣匀能被墨染，但复合组织瓣的前侧和上端染色较浅。摸拟重建手术显示，该种重建方式是可行的。结论：1)应用带血管股骨复合组织瓣重建半骨盆截肢术后的骨与软组织缺损在解剖学上是可行的。可以选择股动脉、股深动及其伴行静脉作为吻合血管。重建时可以将股动脉与髂外动脉或髂内动脉进行吻合；股静脉可以与髂外静脉或髂内静脉进行吻合；股深动脉可以与臀上动脉或臀下动脉进行吻合

2、；股深静脉可以与臀上静脉或臀下静脉进行吻合。2)该复合组织瓣血供丰富，可用于一次性重建半骨盆截肢术后的骨与软组织缺损。关键词：半骨盆截肢术，骨盆重建，股骨，复合组织瓣，解剖学ⅡAbstractABSTRACTBackground：Hindquarteramputationistheexclusivetreatmentforsomehugepelvictumors．Thereusuallycomeslargeboneandsofttissuedefects．LotsofboneandsofttissueCanbeharvestedfromamputatedlimbafter

3、amputation．Howtouseboneandsofttissuefromamputatedlimbreconstructboneandsofttissuedefectsafterhindquarteramputation，whichisaurgentproblemstobesolvedbeforethecommenceofreconstructiveoperationinclinics．Objective：Vascularizedfemurcompositeflapwasdesignedaccordingtotheanatomyofpelvisandthi【曲an

4、dusedtoreconstructboneandsofttissuedefectsafterhindquarteramputation，whichcouldoffertheoreticalsupportandreferringforreconstructionofboneandsofttissuedefectsafterhindquarteramputation．Methods：PartI：Reconstructedpelvicmeasurement．111edistancesfromischialtuberositytoipsilateralauricularsurf

5、aceofSaUl'timandsuperiormarginofpubicsymphysisweremeasuredon10pelves．nelengthoffemurandtibiaon4reconstructedpelvesWasmeasured．nedistancefromforamennutrienstometaphysicWasmeasuredin50femurs。砀edateofharvestedautograftswerecompared纠触thoseofforamennutrienstodeterminethepossibilityofpreservanc

6、ethearteriaenutricia．PartII：Observationofbloodvessels．Redemulsweredabbledfromfemoralarteryin10cadavers，andformalinwereusedforantisepticise．，nlecaliberandlengthofrelatedvesselinpelvicandthighweremeasuredandrecorded。刀抡relatedvesselextemaldiameterswerecomparedtodecidetheproperbloodvesselforr

7、evascularization．PartIII：Designvascularizedfemurcompositeflap．ThehindquarteramputationWassimulatedon6freshcadavers．VascularizedfemurcompositeflapWasdesignedaccordingtoanatomicmeasureresults．Itsareawasmeasuredandcomparedtosofttissuedefectsofpelvicafterhindquarterampu