穿支皮瓣微循环血流量的动态观察及组织学研究  

Study on microcirculation blood flow of perforator flap and its histological changes

作　　者：冯瑞铮[1] 弓军胜[1] 董佳生[2] 

机构地区：[1]山西医科大学第一临床医学院整形外科,太原030001 [2]上海第二医科大学附属第九人民医院整形外科

出　　处：《山西医科大学学报》2009年第11期985-988,共4页Journal of Shanxi Medical University

摘　　要：目的研究大鼠腹部穿支皮瓣形成后微循环血流量的动态变化及组织学改变。方法选取5只SD大鼠作为实验组,建立腹壁上动脉穿支皮瓣模型,在皮瓣蒂部、中段、远段选取3个测量点,于术前、术后不同时段进行微循环血流测量;于术后7d,分别切取皮瓣距蒂部中1/3处组织块及正常5只大鼠(对照组)腹部组织块,光镜下观察组织学改变并进行血管计数,外径、管壁厚度测量。结果皮瓣蒂部、中段、远段在皮瓣形成后的血流变化规律不尽相同,与正常大鼠腹部组织相比,穿支皮瓣内血管增多,微小动静脉管壁变薄。实验组内平均血管密度为(35.55±6.36)个/cm2,对照组为(28.67±5.39)个/cm2。实验组平均血管外径、平均管壁厚度分别为(43.04±8.69)μm和(10.20±3.03)μm,对照组为(32.87±7.80)μm和(15.95±4.71)μm,两组平均血管外径、平均管壁厚度差异有统计学意义(P<0.05)。结论穿支皮瓣形成后皮瓣内原有血管扩张和新生毛细血管长入是其成活的病理生理学基础。Objective To study the dynamic changes of the microcirculation blood flow and histological changes after the formation of abdominal perforator flap. Methods After rat superior epigastric artery perforator flap model was established, the microcirculation blood flow in the pedicle, middle and distal perforator flap were measured before and after operation, respectively. At day 7 after opera- tion,the histological changes of the pedicle flap and normal abdominal tissues of rats were observed under light microscope, and vessel count,vessel outer diameter, and wall thickness were determined. Results The changes of pedicle,middle and distal blood flow after the formation of the flap were different. Compared with the normal abdominal tissues, the vessel numbers inside perforator flap increased, and small artery and vein wall became thinner. The average blood vessel density was （35.55 ± 6.36）/cm^2 in perforator flap and （28.67 ± 5.39 ）/cm^2 in normal abdominal tissues. The average vessel outer diameter was （43.04 ± 8.69） μm in perforator flap, significantly higher than in normal abdominal tissues [ （ 32.87 ± 7.80 ） μm, P 〈 0.05 ]. The average wall thickness was （ 10.20 ± 3.03 ） μm in perforator flap, significantly lower than in normal abdominal tissues [ （ 15.95 ± 4.71 ） μm, P 〈 0. 05 ]. Conclusion The expansion of original blood vessels within the flap and new capillary growth may be the pathophysiological basis of the flap survival.

关 键 词：皮瓣 微循环 平均血管密度 

分 类 号：R622[医药卫生—整形外科]