低能量体外震波扩大随意皮瓣成活面积的实验研究  

Low-energy shockwave therapy enlarges the survival dimension of random-pattern flaps： an experimental study

作　　者：燕晓宇[1] 曾炳芳[1] 柴益民[1] 罗从风[1] 李晓林[1] 刘旭东[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海市200233

出　　处：《中华显微外科杂志》2008年第1期43-46,85,共5页Chinese Journal of Microsurgery

摘　　要：目的观察低能量体外震波（extracoral shock wave，ESW）扩大随意皮瓣成活面积的可能性。方法40只SD大鼠分为对照组和治疗组，各20只。在鼠背部制作蒂位于头侧的随意皮瓣。长10cm，蒂宽3cm，分离后原位缝合。治疗组术后即用1500脉冲0．09mJ／mm^2的ESW对皮瓣进行干预，对照组不作处理。术后第1、3、5、7、10天用激光多普勒血流计测定皮瓣的血流量．大体观察皮瓣内血管分布情况，组织学检查微血管密度，计算皮瓣的存活面积和存活率。结果治疗组皮瓣的中部、远部在各时间段的相对血流量值明显高于对照组；术后10d，治疗组和对照组的微血管密度分别为31．5±4．9和10．3±2．8，皮瓣成活率分别为（78．0±8．0）％和（48．4±6．0）％，成活区的长宽比分别为2．52：1和1．51：1。两组差异均有统计学意义。结论低能量ESW通过增加皮瓣的血流量、促进血管新生而扩大随意皮瓣的成活面积，为扩大随意皮瓣的临床用途提供可能。Objective To investigate the possibility to enlarge the survival dimension of randompattern flaps by low-energy extracorporal shock wave therapy. Methods Forty Sprague-Dawley rats were divided into control group and low-energy ESW treatment group with 20 in each. A cranially based randompattern flap, 10 cm long and 3 cm in the width of the pedicle, was raised on the back of every rat and sutured back to the original place. ESW treatment with 1500 impulses at 0.09 mJ/mm^2 was performed immediately after operation in the treatment group but not in the control. Postoperatively, the blood flow in the flap was measured with laser Doppler flow meter. On the 10th postoperative day, the vessel distribution in the flap was investigated, the capillary density assessed histologically, the surviving area and survival rate calculated. Results In the different periods, blood perfusion in the middle and distal parts of the flaps in treatment group was much higher than that in control group. On the tenth postoperative day the treatment group had a mean capillary density of 31.5 ± 4.9 and a mean survival rate of （77.57 ± 7.13）%, while the control group had a mean capillary density of 10.3 ± 2.8 and a mean survival rate of （39.47 ± 5.78）%. The differences between the two groups were statistically significant（P〈 0.01）. Conclusion Low-energy ESW therapy can increase the blood flow, improve the angiogenesis in the random-pattern flap thus to enlarge its survival dimension, providing the possibility to widen the clinical indication of random-pattern flap transfer.

关 键 词：低能量震波 外科皮瓣 移植 显微外科 大鼠 

分 类 号：R622[医药卫生—整形外科]