中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2014年
2期
141-144
,共4页
模型,动物%显微外科手术%皮肤套脱伤%静脉动脉化
模型,動物%顯微外科手術%皮膚套脫傷%靜脈動脈化
모형,동물%현미외과수술%피부투탈상%정맥동맥화
Models,animal%Microsurgery%Degloving injury of skin%Arterialization
目的 探讨以静脉动脉化法增加血液灌注对大面积套脱皮肤成活的影响.方法 选取健康日本大耳白兔10只,将其双后肢随机分为实验侧和对照侧,制成3.3:1的皮肤逆行套脱伤的动物模型,实验侧将小腿近端胫后动静脉发出的皮肤营养血管切断,将动脉近端与静脉远端吻合,并吻合大隐静脉和小隐静脉;而对照侧只吻合大隐静脉和小隐静脉.结果 对照侧套脱皮肤平均成活50.5％,实验侧套脱皮肤平均成活60.2％,两者差异有统计学意义(P＜0.05);对照侧套脱皮肤平均挛缩31.9％,实验侧套脱皮肤平均挛缩26.9％,两者差异无统计学意义(P＞0.05).血气分析显示,对照侧腹股沟平面的静脉血PaO2为41.32mmHg(1 mmHg=0.133 kPa),实验侧腹股沟平面的静脉血Pa02为60.35 mmHg,两者差异有统计学意义(P＜0.05).结论 静脉动脉化法可增加套脱皮肤的血液灌注,有利于套脱皮肤的成活;但其非生理性血液循环方式对套脱皮肤的成活又有一定的负面影响.
目的 探討以靜脈動脈化法增加血液灌註對大麵積套脫皮膚成活的影響.方法 選取健康日本大耳白兔10隻,將其雙後肢隨機分為實驗側和對照側,製成3.3:1的皮膚逆行套脫傷的動物模型,實驗側將小腿近耑脛後動靜脈髮齣的皮膚營養血管切斷,將動脈近耑與靜脈遠耑吻閤,併吻閤大隱靜脈和小隱靜脈;而對照側隻吻閤大隱靜脈和小隱靜脈.結果 對照側套脫皮膚平均成活50.5％,實驗側套脫皮膚平均成活60.2％,兩者差異有統計學意義(P＜0.05);對照側套脫皮膚平均攣縮31.9％,實驗側套脫皮膚平均攣縮26.9％,兩者差異無統計學意義(P＞0.05).血氣分析顯示,對照側腹股溝平麵的靜脈血PaO2為41.32mmHg(1 mmHg=0.133 kPa),實驗側腹股溝平麵的靜脈血Pa02為60.35 mmHg,兩者差異有統計學意義(P＜0.05).結論 靜脈動脈化法可增加套脫皮膚的血液灌註,有利于套脫皮膚的成活;但其非生理性血液循環方式對套脫皮膚的成活又有一定的負麵影響.
목적 탐토이정맥동맥화법증가혈액관주대대면적투탈피부성활적영향.방법 선취건강일본대이백토10지,장기쌍후지수궤분위실험측화대조측,제성3.3:1적피부역행투탈상적동물모형,실험측장소퇴근단경후동정맥발출적피부영양혈관절단,장동맥근단여정맥원단문합,병문합대은정맥화소은정맥;이대조측지문합대은정맥화소은정맥.결과 대조측투탈피부평균성활50.5％,실험측투탈피부평균성활60.2％,량자차이유통계학의의(P＜0.05);대조측투탈피부평균련축31.9％,실험측투탈피부평균련축26.9％,량자차이무통계학의의(P＞0.05).혈기분석현시,대조측복고구평면적정맥혈PaO2위41.32mmHg(1 mmHg=0.133 kPa),실험측복고구평면적정맥혈Pa02위60.35 mmHg,량자차이유통계학의의(P＜0.05).결론 정맥동맥화법가증가투탈피부적혈액관주,유리우투탈피부적성활;단기비생이성혈액순배방식대투탈피부적성활우유일정적부면영향.
Objective To investigate the influence on the survival of extensively degloved skin by increasing perfusion via venous arterialization.Methods Extensive degloving injury model was created by making 3.3:1 distal-based skin avulsion in 20 rear legs of 10 healthy Japanese white rabbits.The legs of each rabbit were randomly assigned as the experimental side and control side.On the experimental side,nutrition vessels from the posterior tibial artery and vein were severed and the proximal artery was anastomosed to the distal vein.Both the greater and lesser saphenous veins were anastomosed.On the control side only the greater and lesser saphenous veins were anastomosed.Results On the experimental side 60.2％ of the degloved skin survived,while 50.5％ of the degloved skin survived on the control side.The difference was statistically significant (P ＜ 0.05).Skin contraction was 26.9％ on the experimental side and 31.9％ on the control side,the difference not being significant (P ＞ 0.05).Blood gas analysis of groin veins was 41.32 mmHg on the control side and 60.35 mmHg on the experimental side for venous blood PaO2.The difference was statistically significant (P ＜ 0.05).Conclusion Arterialization of the vein can augment blood perfusion of degloved skin and increase skin survival.However,as a non-physiological blood circulation,it also promotes blood congestion,tissue swelling and fibrosis of the degloved skin.
