CAJ | 학술논문

目的：以兔带轴性血管筋膜皮瓣和筋膜组织瓣为实验模型，探讨轴型筋膜皮瓣和筋膜组织瓣的长宽比与皮瓣成活之间的关系。方法在家兔背部两侧以胸背侧动脉为轴性血管构建筋膜皮瓣及组织瓣模型，14只兔子共28个皮瓣。根据组织瓣的长宽比例随机分成4组，每组7个皮瓣。A1组为4∶1的轴型筋膜皮瓣；A2组为4∶1的轴型筋膜组织瓣；B1组为6∶1的轴型筋膜皮瓣；B2组为6∶1的轴型筋膜组织瓣。完全游离后，原位缝合皮瓣和组织瓣，观察其存活情况。术后15天对皮瓣进行拍照、使用 Scion Image 软件分析，记录皮瓣的成活情况进行统计学分析。在每组皮瓣中选取7个皮瓣进行微动脉造影，观察微循环情况。结果术后15天各组皮瓣成活率(成活面积的百分率)测定结果为：A1组皮瓣愈合良好，表层均有新毛长出，皮瓣全部成活，成活率为100%；A2组成活率为100%，但有1个皮瓣发生感染，其余皮瓣术后面积缩小显著；B1组皮瓣成活率(90.22±8.6)%。B2组去掉表面皮片显示筋膜组织瓣成活情况，成活率100%。经t 检验 B1组成活面积的百分率较 A 组，B2组均低，t＝3.004，P＝0.04差异有统计学意义。微动脉造影显示皮瓣术后血管通畅，并且皮瓣术后有侧枝循环形成。结论家兔的轴型筋膜皮瓣与筋膜组织瓣在长宽比6∶1下的成活率是可靠的，且轴型筋膜组织瓣的成活率比筋膜皮瓣更高。微动脉造影术能直观的显示出皮瓣的微循环情况，是皮瓣研究的重要手段之一。
목적：이토대축성혈관근막피판화근막조직판위실험모형，탐토축형근막피판화근막조직판적장관비여피판성활지간적관계。방법재가토배부량측이흉배측동맥위축성혈관구건근막피판급조직판모형，14지토자공28개피판。근거조직판적장관비례수궤분성4조，매조7개피판。A1조위4∶1적축형근막피판；A2조위4∶1적축형근막조직판；B1조위6∶1적축형근막피판；B2조위6∶1적축형근막조직판。완전유리후，원위봉합피판화조직판，관찰기존활정황。술후15천대피판진행박조、사용 Scion Image 연건분석，기록피판적성활정황진행통계학분석。재매조피판중선취7개피판진행미동맥조영，관찰미순배정황。결과술후15천각조피판성활솔(성활면적적백분솔)측정결과위：A1조피판유합량호，표층균유신모장출，피판전부성활，성활솔위100%；A2조성활솔위100%，단유1개피판발생감염，기여피판술후면적축소현저；B1조피판성활솔(90.22±8.6)%。B2조거도표면피편현시근막조직판성활정황，성활솔100%。경t 검험 B1조성활면적적백분솔교 A 조，B2조균저，t＝3.004，P＝0.04차이유통계학의의。미동맥조영현시피판술후혈관통창，병차피판술후유측지순배형성。결론가토적축형근막피판여근막조직판재장관비6∶1하적성활솔시가고적，차축형근막조직판적성활솔비근막피판경고。미동맥조영술능직관적현시출피판적미순배정황，시피판연구적중요수단지일。
Objective To explore the relationship between the length / width ratio and survival rate of the lfap with the rabbit axial pattern fascio-cutaneous lfap and adipofascial lfap as the experimental model.Methods Axial pattern faciocutaneous lfap and adipofascial lfap were created on both sides of the rabbit back with the thoracodorsal artery as the axial vessel. Fourteen rabbits were involved in the study with 28 lfaps, which were randomly divided into 4 groups based on the length / width ratio of the lfaps with 7 lfaps in each. Group A1: 4:1 axial patten fascio-cutaneous lfap. Group A2: 4:1 axial pattern adipofascial lfap. Group B1: 6:1 axial pattern fascio-cutaneous lfap. Group B2: 6:1 axial pattern adipofascial lfap. Following dissection the lfaps were sutured back in situ and survival condition was observed. Fifteen days after operation photos were taken and results were analyzed with Scion Image software to observe and record the survival of the individual lfaps. Statistical analysis was done. Micro-arterial angiography was done to demonstrate microcirculation in the lfaps.Results Fifteen days after operation the percentage of the survived portion of the lfaps was measured to ifnd a survival rate of ( 100±0.0 ) % in group A1 with well growth of new hair, a survival rate of 100% in Group A2 with infection in 1 lfap and obvious shrihkage in all lfaps, an averaged survival rate of ( 90.22±8.6 ) % in Group B1, and a survival rate of 100% in Group B2. The t test revealed that the survival rate of the lfaps in Group B1 was statistically lower with those in Group A and Group B2 witht=3.004,P=0.04. The micro-arterial angiography demonstrated the vascular pedicles of the lfaps were patent and the collateral circulation formed well after the operation.Conclusions At the length / width ratio of 6:1, both axial pattern fascio-cutaneous lfap and adipofascial lfap can survive safely in rabbits and axial adipofascial lfaps may have a higher survival rate than axial pattern fascio-cutaneous lfaps. Micro-arterial angiography can demonstrate the circulation status in lfaps intuitively, thus being an important procedure in lfap study.