中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2015年
2期
144-148
,共5页
王培吉%周聚普%江波%赵家举%张勇
王培吉%週聚普%江波%趙傢舉%張勇
왕배길%주취보%강파%조가거%장용
逆行岛状皮瓣%内增压%静脉回流%成活率
逆行島狀皮瓣%內增壓%靜脈迴流%成活率
역행도상피판%내증압%정맥회류%성활솔
Reverse-flow island flaps%Pressurization%Venous drainage%Survival rate
目的 通过新西兰大白兔活体动物实验模型,探讨改变动、静脉之间压力差对逆行岛状皮瓣成活面积的影响. 方法 选用新西兰大白兔隐动、静脉设计逆行岛状皮瓣的实验模型.实验动物随机分为4组.A组:对照组(保留皮瓣蒂部浅静脉干的完整性);B组:隐动脉部分吻合组(皮瓣内的隐动脉近心端切断后,管径修剪为原来的一半,行端端吻合);C组:静脉干部分吻合组(皮瓣浅静脉干近心端切断后,管径修剪为原来的一半,再行端端吻合);D组:浅静脉干结扎组(皮瓣蒂部浅静脉干予以结扎).术后大体观察皮瓣成活的一般情况,测定皮瓣成活面积并比较皮瓣成活率的差异,应用核素扫描观察皮瓣在不同时间血液分布情况,组织学检测观察皮瓣内的血管分布及血管内的血细胞存在状态. 结果 B组皮瓣成活率为(82.27±11.71)％,高于A、C和D组[分别为(47.70±11.18)％、(61.26±13.93)％和(61.38±12.67)％],差异有统计学意义(P＜0.05);B组与A组相比,差异也有统计学意义(P＜0.05).核素扫描结果显示B组可见到明显的放射性物质通过,A、C、D组放射性物质均为一过性存在.术后10 d时,组织学观察显示B组与其他组相比可见较多毛细血管再生及血细胞存留. 结论 通过增加皮瓣动脉血供可增加皮瓣的成活面积,单纯促进静脉回流不能有效提高皮瓣的成活率.
目的 通過新西蘭大白兔活體動物實驗模型,探討改變動、靜脈之間壓力差對逆行島狀皮瓣成活麵積的影響. 方法 選用新西蘭大白兔隱動、靜脈設計逆行島狀皮瓣的實驗模型.實驗動物隨機分為4組.A組:對照組(保留皮瓣蒂部淺靜脈榦的完整性);B組:隱動脈部分吻閤組(皮瓣內的隱動脈近心耑切斷後,管徑脩剪為原來的一半,行耑耑吻閤);C組:靜脈榦部分吻閤組(皮瓣淺靜脈榦近心耑切斷後,管徑脩剪為原來的一半,再行耑耑吻閤);D組:淺靜脈榦結扎組(皮瓣蒂部淺靜脈榦予以結扎).術後大體觀察皮瓣成活的一般情況,測定皮瓣成活麵積併比較皮瓣成活率的差異,應用覈素掃描觀察皮瓣在不同時間血液分佈情況,組織學檢測觀察皮瓣內的血管分佈及血管內的血細胞存在狀態. 結果 B組皮瓣成活率為(82.27±11.71)％,高于A、C和D組[分彆為(47.70±11.18)％、(61.26±13.93)％和(61.38±12.67)％],差異有統計學意義(P＜0.05);B組與A組相比,差異也有統計學意義(P＜0.05).覈素掃描結果顯示B組可見到明顯的放射性物質通過,A、C、D組放射性物質均為一過性存在.術後10 d時,組織學觀察顯示B組與其他組相比可見較多毛細血管再生及血細胞存留. 結論 通過增加皮瓣動脈血供可增加皮瓣的成活麵積,單純促進靜脈迴流不能有效提高皮瓣的成活率.
목적 통과신서란대백토활체동물실험모형,탐토개변동、정맥지간압력차대역행도상피판성활면적적영향. 방법 선용신서란대백토은동、정맥설계역행도상피판적실험모형.실험동물수궤분위4조.A조:대조조(보류피판체부천정맥간적완정성);B조:은동맥부분문합조(피판내적은동맥근심단절단후,관경수전위원래적일반,행단단문합);C조:정맥간부분문합조(피판천정맥간근심단절단후,관경수전위원래적일반,재행단단문합);D조:천정맥간결찰조(피판체부천정맥간여이결찰).술후대체관찰피판성활적일반정황,측정피판성활면적병비교피판성활솔적차이,응용핵소소묘관찰피판재불동시간혈액분포정황,조직학검측관찰피판내적혈관분포급혈관내적혈세포존재상태. 결과 B조피판성활솔위(82.27±11.71)％,고우A、C화D조[분별위(47.70±11.18)％、(61.26±13.93)％화(61.38±12.67)％],차이유통계학의의(P＜0.05);B조여A조상비,차이야유통계학의의(P＜0.05).핵소소묘결과현시B조가견도명현적방사성물질통과,A、C、D조방사성물질균위일과성존재.술후10 d시,조직학관찰현시B조여기타조상비가견교다모세혈관재생급혈세포존류. 결론 통과증가피판동맥혈공가증가피판적성활면적,단순촉진정맥회류불능유효제고피판적성활솔.
Objective To investigate the effects of changing the arteriovenous pressure difference on the survival area of reverse island flap in New Zealand white rabbits models.Methods The saphenous artery and saphenous vein of New Zealand rabbits were selected to design experimental models of reverse island flap.Experi mental rabbits were randomly divided into 4 groups:group A:control group (reserved pedicle integrity of superficial veins);group B:part anastomosis of saphenous artery group (the distal saphenous artery of the flap was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group C:part anastomosis of vein group (distal superficial veins was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group D:ligated superficial veins group (pedicle superficial veins was ligated).After surgery,the flaps were measured by general observation.Blood distribution at different times of the flaps was detected by radionuclide scans.Survival area of the flap was measured to compare the survival rate of flap.Distribution of blood vessels and the state of blood cells were observed by Histological examination.Results The flap survival rate was (82.27-± 11.71)％ in group B,showing significant differences when compared with that group A (47.70-± 11.18)％,group C (47.70 ± 11.18)％ and group D (47.70 ± 11.18)％ (P ＜ 0.05).Radionuclide scans showed that the radioactive material in group B could be seen clearly,the radioactive material in groups A,C and D were a transient existence.Ten days postoperatively,histological observation showed that group B had more capillary regeneration and blood cells remain compared with other groups.Conclusion Increase the blood supply can increase the survival area of the reverse island flap,and simply promote the venous drainage can not effectively improve the survival rate of the flap.
