延迟术通过加强血管扩张的方式促进跨区皮瓣存活

doi:10.13418/j.issn.1001-165x.2015

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (1): 44-50.doi: 10.13418/j.issn.1001-165x.2015

延迟术通过加强血管扩张的方式促进跨区皮瓣存活

庄跃宏¹，梁成²，温福利²，谢志平²，郑和平²

1.福建医科大学人体解剖与组织胚胎学系, 福州 350025; 2.福建医科大学福总临床医学院( 南京军区
福州总医院) 比较医学科，福州 350108

收稿日期:2014-10-10 出版日期:2015-01-25 发布日期:2015-02-12
通讯作者: 郑和平，教授，主任医师，硕士生导师，E-mail: zhpfz@163.com E-mail:zhuangyuehong@163.com
作者简介:庄跃宏(1984-)，男，副教授，博士，主要从事皮瓣血供的基础研究
基金资助:
国家自然资金(31401023)；福建省教育厅基金（JK2013020）；福建省自然基金（2014J05090）

Augmentation of survival of extended flap by delayed surgery through enhancement of dilation of choke vessels

ZHANG Yue-hong¹, LIANG Cheng², WEN Fu-li², XIE Zhi-ping², ZHENG He-ping²

1.Department of Anatomy and Histoembryology, Fujian Medical University, Fuzhou 350025, China;
2.Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou 350108, China

Received:2014-10-10 Online:2015-01-25 Published:2015-02-12

摘要/Abstract

摘要：

目的　在小鼠耳上建立耳瓣延迟模型，探究延迟术促进组织存活的原因。方法 ICR小鼠30只，等分入延迟组、非延迟组及分叉以下组。延迟组小鼠先在中间血管体分叉即上水平做一切口，1周后再切开尾侧血管体；非延迟组小鼠在中间血管体分叉即上水平剪断尾侧与中间血管体；分叉以下组在中间血管体分叉即下水平剪断中间与尾侧血管体。术后对3组耳瓣的坏死率进行测量，对延迟组与非延迟组耳瓣内不同位置出现显著管径变化的choke血管的数量及管径进行计数与测量。结果延迟组、非延迟组及分叉以下组最终坏死率分别为（7.7±4.8）%、(31.0±12.4)%及(15.4±7.4)%，有显著性统计学差异(P=0.003)。延迟组小鼠平均每耳瓣出现(8.8±2.0)根有显著形态学变化的choke血管；非延迟组小鼠平均每耳瓣出现(6.5±1.2)根，显著少于延迟组（t=3.083，P=0.006）。延迟组小鼠耳瓣内choke静脉的扩张幅度显著大于非延迟组，延迟组小鼠耳瓣内平均血管内阻力显著小于非延迟组。结论延迟术通过加强choke血管扩张的方式促进皮瓣的存活。中间血管的类型及处理方式可能对跨区皮瓣的存活起重要作用。

关键词: 延迟术, 跨区皮瓣, choke血管, 耳瓣, 小鼠

Abstract:

Objective To investigate the delay phenomenon in a mouse’s ear-flap mode. Methods 30 male mice were equally divided into the delay group, non-delay group, and below-the-division group. In the delay group, an incision was first made in the middle angiosome right above the division. One week later, the tail-oriented angiosome was severed. In the non-delay group, the ear flap was created by severance of the middle and tail-oriented angiosomes at the level right above the division of the middle angiosome. In the below-the-division group, the ear flap was created by severance of the middle and tail angiosomes at the level right below the division of the middle angiosome. After the creation of the ear flap，The necrotic rate of the ear flaps in the three groups at various time points was calculated; the number and diameter change of the choke vessels that underwent remarkable dilation were recorded and measured. Results After the creation, the final necrotic rate of flaps in the delay group, non-delay group, below-the-division group was (7.7±4.8)%, (31.0±12.4)% and (15.4±7.4)%, respectively. There was significant difference among the necrotic rate in the three groups (P=0.003). In the delay group, each ear flap has an average of 8.8±2.0 choke vessels that underwent remarkable morphological changes in each ear, whereas in the non-delay group there were an average of 6.5±1.2 choke vessels in each ear, being significantly less than that in delay group（t=3.083，P=0.006）. The magnitude of the diameter dilation of choke veins in the delay group was remarkably larger than that in the non-delay group. The average intravascular resistance in the delay group was remarkably smaller than that in the delay group. Conclusion The delay surgery augments the survival of large-sized flap through enhancement of dilation of choke vessels. The type and handling approach to the middle angiosome might have significant impact on the survival of the flap.

Key words: Delay surgery, Extended flap, choke vessels, Ear flap, Mouse

中图分类号:

庄跃宏, 梁成, 温福利, 谢志平, 郑和平. 延迟术通过加强血管扩张的方式促进跨区皮瓣存活[J]. 中国临床解剖学杂志, 2015, 33(1): 44-50.

PENG Ti-Hong, LIANG Cheng, WEN Fu-Li, XIE Zhi-Beng, ZHENG He-Beng. Augmentation of survival of extended flap by delayed surgery through enhancement of dilation of choke vessels[J]. Chinese Journal Of Clinical Anatomy, 2015, 33(1): 44-50.

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延迟术通过加强血管扩张的方式促进跨区皮瓣存活

Augmentation of survival of extended flap by delayed surgery through enhancement of dilation of choke vessels

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