摘要
目的用荧光示踪法研究皮神经浅静脉营养血管远端蒂皮瓣的静脉回流，探讨静脉回流的规律。方法分别取20只新西兰兔耳静脉血各0．1ml，分离红细胞并标记、检测。在20只动物后肢建立小隐静脉腓肠神经营养血管远端蒂皮瓣模型。按照皮瓣生成后检测的时间即术后30min、1，2和7d分成A、B、C、D四组。取标记好的红细胞悬液5μl，在各组通过小隐静脉（A、B组）或皮下组织（C、D组）注入。5s（A、B组）或10s（C、D组）后取下皮瓣立即冷冻、切片、染色，分析荧光在血管蒂部的分布。结果标记的红细胞荧光强度均匀稳定。冰冻切片显示荧光分布在小隐静脉壁及周围血管、穿动脉的内膜外膜，B、C、D组在腓肠神经出现弱的荧光分布，HE染色显示C、D组小隐静脉管腔内充满血栓。结论皮神经浅静脉营养血管远端蒂皮瓣的静脉主要通过小隐静脉壁及周围血管、穿动脉的内外膜回流。小隐静脉腔发生栓塞，没有出现逆瓣膜的静脉回流。
Objective To investigate the venous drainage of lesser saphenous sural neurovenofasciocutaneous distally based flap through fluorescence tracing technique and discuss the pattern of venous drainage. Methods Venous blood for 0. 1 ml was collected from every rabbit ear vein of 20 rabbits respectively for separation of the erythrocytes and labeling with FITC. The lesser saphenous sural neurovenofasciocutaneous distally based flaps were successfully established in hind limbs of 20 rabbits that were then allocated into four groups according to different inspection time points at 30 minutes （Group A）, 24 hours （ Group B）, 72 hours （ Group C） and 7 days （ Group D） after operation. The labeled erythrocytes （5 μl） were injected into the flaps via lesser saphenous vein （in Groups A and B）or hypoderma （in Groups C and D）. Then, the flaps were removed five seconds （in Groups A and B） or 10 seconds （in Groups C and D） after injection, immediately frozen and sectioned （5-7 μm in thickness） for microscopic analysis of fluorescent distribution in the pedicle. Results FITC-labeled red blood cells showed steady green fluorescence under inversion fluorescence microscope. Fluorescence was mainly distributed in the wall of lesser saphenous vein and peripheral vessels, as well as inner and outer membrane of perforator artery. There was only faint fluorescence around sural nerve in Groups B, C and D. HE staining showed that the lumina of lesser saphenous vein in Groups C and D were fully filled with thrombosis. Conclusions Vein of the lesser saphenous sural neurovenofasciocutaneous distally based flaps is refluxed mainly through wall of lesser saphenous vein and peripheral vessels as well as through inner and outer membrane of perforator artery in the pedicle. Thrombosis occurs in the lumina of lesser saphenous but there is no venous blood reflux through the valve of lesser saphenous vein.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2009年第4期303-306,共4页
Chinese Journal of Trauma
基金
国家自然科学基金资助项目（C03030306）
