头静脉营养血管远端蒂复合瓣的解剖学研究  

Establishing models of portal vein occlusion and value of multi-slice CT in the evaluation of hepatic VX2 tumor in rabbits

作　　者：张发惠 林松庆 郑和平 张国栋 

机构地区：解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心,福建省福州市350025

出　　处：《中国临床康复》2006年第48期219-221,225,共4页Chinese Journal of Clinical Rehabilitation

基　　金：福建省自然科学基金资助项目（C0510034）

摘　　要：背景：前臂皮神经营养血管远端蒂皮瓣，特别适宜手部远端的组织缺损修复，但由于皮瓣旋转轴点较高，时常难以满足修复手部远侧创伤缺损的需要，还会对供区造成较大的损害。目的：观察前臂桡侧缘远端动脉穿支的解剖走行，为前臂桡侧缘头静脉营养血管远端蒂复合瓣的设计提出解剖学理论。设计：单一样本实验。单位：解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心。材料：实验于2004-08／12在解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心实验室完成。30侧动脉内灌注红色乳胶成人上肢标本（由解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心提供）。方法：以桡骨茎突为观测标志点，采用游标卡尺、直尺测量血管外径、距离。主要观察指标：①前臂桡侧缘远端的动脉穿支。②多头静脉的营养血管。③营养血管与邻近骨、皮和前臂外侧皮神经的血供关系。④多头静脉的浅深交通支。结果：前臂桡侧缘远端的动脉穿支来自：桡动脉的皮支6-11支．外径（0．7±0．3）mm；掌浅支的皮支2-6支，外径（0．5±0．3）mm；桡骨茎突返支的皮支1-2支，外径（0．5±0．1）mm；鼻烟壶支的皮支1-2支，外径（0．6±0．2）mm。在桡骨茎突上方8．0-15．0cm，桡动脉肌间隙骨皮穿支1-3支，外径（1．1±0．2）mm，分布桡骨体部中下段的裸露区及相应区域的皮肤。上述动脉穿支均发皮支、筋膜支、骨膜支、头静脉和皮神经远端营养血管支，形成头静脉旁血管链和皮神经干血管链以及深、浅筋膜和骨膜血管网。结论：前臂桡侧缘远端的动脉穿支是头静脉营养血管的来源，营养血管又与邻近的骨、皮和前臂外侧皮神经的营养血管同源，是设计头静脉营养血管远端蒂复合瓣的解剖学基础。以桡骨茎突返支（或鼻烟壶支�BACKGROUND： Clinical researches found that portal vein occlusion was beneficial to inhibit growth of hepatocarcinoma, promote compensatory hyperplasia of un-blocking hepatic tissue and decrease metastasis of portal vein occlusion; however, it should be further proved by animal experiments. OBJECTIVE： To investigate models of portal vein occlusion of hepatic VX2 tumor in rabbits and evaluate value of multi-slice CT. DESIGN： Randomized grouping design and animal study. SETTING： Department of Radiology, Xinqiao Hospital of the Third Military Medical University of Chinese PLA. MATERIALS： The experiment was carried out in the Imaging Department of Xinqiao Hospital of the Third Military Medical University of Chinese PLA from July 2002 to January 2005. Forty New Zealand rabbits were divided according to digital table into 4 groups： immediate group （transplantation of tumor after immediate portal vein occlusion）, 3-week group （transplantation of tumor at 3 weeks after portal vein occlusion）, negative control group and positive control group, 10 in each group. METHODS： Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation at immediate portal vein occlusion and 3 weeks after portal vein occlusion. Meanwhile, they were divided into negative control group （Left external branch of portal vein was done sham-operative block, and left exite was embedded and inoculated pseudoly） and positive control group （Transplanted tumor did not suffer from portal vein occlusion）. All rabbits were scanned with multi-slice CT. MAIN OUTCOME MEASURES： General changes of liver, changes of tumor, metastasis of tumor, vascular-imaging displaying rate of multi-slice CT of hepatic artery and portal vein, blood flow of liver, blood volume, mean transit time, permeability of vascular surface and fraction of hepatic arterial infusion （HAI）. RESULTS： All 40 animals were involved in the final analysis.①Tumor did not grow in both immediate group and 3-week group. In 3-week group, left endite was at

关 键 词：头臂静脉 前臂 外科皮瓣 

分 类 号：R543.4[医药卫生—心血管疾病]