CAJ | 학술논문

目的建立大鼠腹壁动脉穿支(DEP)模型,观察无干预情况下皮瓣成活过程.方法观察大鼠腹壁穿支血管解剖,构建单一腹壁肌皮穿支血供模型,皮瓣上至肋弓缘,下至髂前上棘,侧至腋中线.术后观察皮瓣,检测微血管密度、胶原含量.结果构建以右腹壁第2肌皮穿支血管为单一血供的3.0 cm×6.5 cm～3.0 cm×7.0 cm皮瓣,单一穿支血管可供养皮瓣.术后1周存活区界限出现;2周坏死区完全变黑干缩.术后早期(1～3 d)以组织水肿和炎性细胞浸润为主,晚期(7～14 d)以血管生成和胶原沉积为主.术后1～3 d皮瓣MVD上升(P<0.05),胶原含量下降但无统计学意义(P>0.05);3～5 d均渐上升(P<0.05),分别在第5天和第10天左右达到高峰(P<0.01),后维持在较高水平.结论大鼠DEP模型是稳定可靠的穿支皮瓣乳房再造研究模型.
목적 건립대서복벽동맥천지(DEP)모형,관찰무간예정황하피판성활과정.방법 관찰대서복벽천지혈관해부,구건단일복벽기피천지혈공모형,피판상지륵궁연,하지가전상극,측지액중선.술후관찰피판,검측미혈관밀도、효원함량.결과 구건이우복벽제2기피천지혈관위단일혈공적3.0 cm×6.5 cm～3.0 cm×7.0 cm피판,단일천지혈관가공양피판.술후1주존활구계한출현;2주배사구완전변흑간축.술후조기(1～3 d)이조직수종화염성세포침윤위주,만기(7～14 d)이혈관생성화효원침적위주.술후1～3 d피판MVD상승(P<0.05),효원함량하강단무통계학의의(P>0.05);3～5 d균점상승(P<0.05),분별재제5천화제10천좌우체도고봉(P<0.01),후유지재교고수평.결론 대서DEP모형시은정가고적천지피판유방재조연구모형.
Objective To establish a stable rat deep epigastric perforator (DEP) model and record the flap survival progress without interference. Methods The anatomical characteristics of the musculocutaneous perforating vessels were investigated, and a single deep epigastric perforator flap was established,subsequently. The upper bound of the flap was costal margin,the lower bound was the level of the anterior superior iliac spine, and the lateral bound was midaxillary line. The flaps survival progress was recorded,and the microvessel density (MVD) and collagen deposition at different time points were examined by immunodetection of VWF and picric-sirius red stain,respectively. Results The 2nd perforator was selected as supplying vessels for the DEP flap,whose area was 3.0 cm × 6.5 cm-3.0 cm × 7.0 cm. The boundary between survival and necrotic zones appeared one week after operation. The skin-color and capillary reaction in the survival zone restored to the normal manifestations and the necrosis region became black and hard drying completely at the second week. In the early period (1-3 days) post-operation,tissue edema and infiltration of inflammatory cells were observed, while in later period (7-14 days) angiogenesis and collagen deposition were observed. The MVD was increased significantly (P < 0. 05), but collagen deposition decreased un-significantly (P>0.05) in the first 3 days post-operation,gradually elevated in the 3-5days (P<0.05) .reached the peak at the 5th and 10th day (P< 0.001) .respectively,and remained the high level up to the end of the experiment,subsequently. Conclusion Rat DEP model is a stable and reliable flap animal one for human deep inferior epigastric perforator (DIEP) flap breast reconstruction.