학술논문
下肢CT血管造影及三维重建辅助下术前预设计腓肠神经-小隐静脉筋膜皮瓣的临床应用效果 / Clinical application of pre-designed sural small-saphenous vascular fascial flap assisted by lower limb CTA and three-dimensional reconstruction
Document Type
Academic Journal
Author
Source
中国医刊 / Chinese Journal of Medicine. 59(2):172-176
Subject
Language
Chinese
ISSN
1008-1070
Abstract
目的 探讨下肢CT血管造影(CTA)及三维重建辅助下术前预设计腓肠神经-小隐静脉筋膜皮瓣的临床应用价值.方法 选取2022年1月至2023年6月在首都医科大学附属北京积水潭医院烧伤科行腓肠神经-小隐静脉筋膜皮瓣修复小腿或足踝处创面的24例患者,在组间基线特征可比的基础上,采用随机数字表法分为CTA辅助组和传统手术组,每组12例.CTA辅助组术前行下肢CTA并使用Mimics 21.0软件重建皮瓣相关血管网络,设计模拟切取皮瓣后转化为实体标记以辅助后续手术操作,传统手术组仅按传统手术流程治疗.比较两组患者的一般资料、术中皮瓣切取时长、术后2～3周皮瓣存活及创面覆盖情况.结果 两组患者的年龄、性别、基础疾病、不良烟酒嗜好情况比较差异无统计学意义(P＞0.05).CTA辅助组术中皮瓣切取时长为(21.83±3.91)min,明显短于传统手术组的(26.67±4.05)min,差异有统计学意义(P＜0.05).两组皮瓣存活及创面覆盖情况比较差异无统计学意义(P＞0.05).结论 利用下肢CTA及三维重建在术前预设计腓肠神经-小隐静脉筋膜皮瓣可有效降低手术难度、缩短手术时长,是一种较好的临床辅助方法.
Objective To explore the clinical significance and value of pre-designed sural small-saphenous vascular fascial flap assisted by lower limb CT angiography(CTA)and three-dimensional(3D)reconstruction.Method Patients who were admitted to the Department of Burns,Beijing Jishuitan Hospital of Capital Medical University from January 2022 to June 2023 and required sural small-saphenous vascular fascial flap to repair the wounds on the leg or ankle were randomly divided into 2 groups:the CTA assisted surgery group and the traditional surgery group,the former underwent lower limb CTA before surgery and used Mimics 21.0 software to reconstruct the flap related vascular network,designed a simulated incision of the flap and transformed it into a solid marker on the patients'leg to assist subsequent surgery.While the latter was treated only according to the traditional surgical procedures.Age,sex,basic diseases,bad habit of tobacco and alcohol,duration of incision of the skin flap during operation,survival of the skin flap 2-3 weeks after operation and wound coverage were recorded in the two groups.The results were statistically analyzed by SPSS 23.0 statistical software.Result Twenty-four patients were included,12 in each group.There was no statistical significance in age,gender distribution,basic diseases and bad habit of tobacco and alcohol between the two groups(P＞0.05).The duration of incision of the skin flap in the CTA assisted surgery group was significantly shorter than that in the traditional surgery group,with statistical significance[(21.83±3.91)min vs(26.67±4.05)min,P＜0.05].There was no statistical significance in skin flap survival and wound coverage between the two groups(P＞0.05).Conclusion Pre-designed sural small-saphenous vascular fascial flap with the help of lower limb CTA and 3D reconstruction can effectively reduce the difficulty of operation and shorten the operation time,and is a good clinical auxiliary method.
Objective To explore the clinical significance and value of pre-designed sural small-saphenous vascular fascial flap assisted by lower limb CT angiography(CTA)and three-dimensional(3D)reconstruction.Method Patients who were admitted to the Department of Burns,Beijing Jishuitan Hospital of Capital Medical University from January 2022 to June 2023 and required sural small-saphenous vascular fascial flap to repair the wounds on the leg or ankle were randomly divided into 2 groups:the CTA assisted surgery group and the traditional surgery group,the former underwent lower limb CTA before surgery and used Mimics 21.0 software to reconstruct the flap related vascular network,designed a simulated incision of the flap and transformed it into a solid marker on the patients'leg to assist subsequent surgery.While the latter was treated only according to the traditional surgical procedures.Age,sex,basic diseases,bad habit of tobacco and alcohol,duration of incision of the skin flap during operation,survival of the skin flap 2-3 weeks after operation and wound coverage were recorded in the two groups.The results were statistically analyzed by SPSS 23.0 statistical software.Result Twenty-four patients were included,12 in each group.There was no statistical significance in age,gender distribution,basic diseases and bad habit of tobacco and alcohol between the two groups(P＞0.05).The duration of incision of the skin flap in the CTA assisted surgery group was significantly shorter than that in the traditional surgery group,with statistical significance[(21.83±3.91)min vs(26.67±4.05)min,P＜0.05].There was no statistical significance in skin flap survival and wound coverage between the two groups(P＞0.05).Conclusion Pre-designed sural small-saphenous vascular fascial flap with the help of lower limb CTA and 3D reconstruction can effectively reduce the difficulty of operation and shorten the operation time,and is a good clinical auxiliary method.