摘要
目的 :建立新西兰大白兔隐动静脉逆行岛状皮瓣实验模型 ,探讨静脉逆向回流的机制。方法 :对 5只新西兰大白兔解剖观察 ,建立隐动静脉逆行岛状皮瓣实验模型 ( 3 .0cm× 3 .0cm ,血管蒂长 3 .0cm )。将 10只兔的两侧后肢随机配对分为 2组 ,进行同体对照 ,每组 10个皮瓣。组 1保留隐动静脉血管鞘的完整 ,即保留静脉回流的“迷路”通道。组 2在手术显微镜下 (× 10 )将 3根血管相互分开 ,各自游离 3cm ,即完全破坏静脉回流的“迷路”通道 ,但不损伤 3根动静脉血管。术中放松止血带后分别在 5、15、3 0和60min测定静脉压力 ,术后 10d测定皮瓣成活率 ,切取血管蒂做切片观察。结果 :放松止血带后 ,两组皮瓣的静脉压力均升高 ,约 15min达到高峰 ,后缓慢下降 ,约在 3 0min达到新的平衡。组 2在 3 0、60min的静脉压力均显著低于组 1(P <1.0 1)。但组 1皮瓣成活率 ( 94.5 % )与组 2 ( 10 0 % )无显著差别 (P >0 .0 5 )。结论 :在逆行岛状皮瓣中 ,瓣膜失活途径”较“迷宫途径”更容易实现静脉血的逆流。
Objective: To establish a rabbit model of reverse-flow island flap and investigate the mechanicsm of venous reverse flow. Methods: The saphenous reverse-flow island fasciocutaneous flap (3.0 cm×3.0 cm in size with vascular pedicle length of 3.0 cm) was successfully established in New Zealand White rabbit.Ten rabbits were randomly allocated into 2 groups of 10 flaps.In group I,the vascular pedicle (1 saphenous artery and 2 venae commutantes) was raised and its sheath was not disturbed, maintaining communicating and collaterall branches intact.In group Ⅱ, after vascular elevation, its sheath was microsurgically removed and the threevessels were separated with each other for 3 cm.Introvenous pressure was measured at 5,15,30 and 60 minutes after tourniquet releasee.Flap survival rate was measured in 10 days.The vascular pedicle was harvested and examed histologyically.Results:After releasing of tourniquet,the intravenous pressure increased rapidly and reached its top value in about 30 minutes.In group Ⅱ, the values of intravenous pressure in each time interval of 30 and 60 minutes were significantly lower (P<0.01) than that of group I.But flap survival rate of group I(94.5%) and group Ⅱ(100%) was not significantly different.Histological examination showed the saphenous veins in group Ⅱ was more dilated than that of group I.Conclusion: Venous retrograde return in reverse-flow island flaps can be achieved more easily through 'incompetent valves route' than through 'communicating and collaterall by pass route'.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2004年第1期5-7,共3页
Chinese Journal of Clinical Anatomy
基金
中国博士后科学基金资助项目 (2 0 0 2 0 31 1 76)
关键词
皮瓣模型
外科皮瓣
逆行岛状皮瓣
静脉逆流
兔
flap model
surgical flap
reverse-flow island flap
venous retrograde return
rabbit
