不同参数间歇正压对随意皮瓣成活率的影响  

Effects of different intermittent positive pressure on random pattern flap survival

作　　者：姚庆君[1] 徐明达[1] 陈壁[1] 李永林[1] 

机构地区：[1]第四军医大学西京医院整形外科中心烧伤外科

出　　处：《第四军医大学学报》1999年第5期453-454,共2页Journal of the Fourth Military Medical University

摘　　要：目的：了解间歇式正压对随意皮瓣成活率影响及筛选间歇式正压参数：不同压力、不同加压时间、不同间歇时间．方法：我们将压力分为０，２．５，５．０，７．５ｋＰａ４个水平，加压时间分为１，４，７ｍｉｎ３个水平，时间与压力交叉组合成１２个随机单位组．取健康小白猪６只，沿中线两侧各切取１６ｃｍ×４ｃｍ随意皮瓣２个，每２个皮瓣随机分一个单位组，皮瓣外置施压硅胶囊，加压７ｄ后测量皮瓣成活长度．间歇时间分为１，４，７ｍｉｎ３组，方法同前，每组８个皮瓣．结果：多元分析结果显示：①在压力与加压时间两因素提高皮瓣成活中，仅压力的主效应有统计学意义（Ｐ＝０．０００）；在两因素的单独效应中，压力在７．５ｋＰａ与加压时间在１ｍｉｎ水平较其它水平强；压力与加压时间两因素有协同作用（Ｐ＝０．０００３）；加压７．５ｋＰａ组随意皮瓣成活长度与空白对照组间有显著差别（ｎ＝６，Ｐ＝０．０１０２），皮瓣成活长度平均加长４．８ｃｍ，长宽比分别为２．６７∶１，１．４５∶１．②间歇时间为１，４，７ｍｉｎ时随意皮瓣的平均成活长度分别为９．８，１０．７，９．１ｃｍ，间歇时间４ｍｉｎ组与７ｍｉｎ组间有显著性差别（Ｐ＝０．００８４）．结论：间歇式正压能显著提高随意皮?AIM:To investigate the effects of the intermittent positive pressure on random pattern flap survival and select the best parameters of the pressure: the pressure force, pressure time and intermittent time. METHODS: Four pressures (0, 2.5, 5.0 and 7.5 kPa), and three pressure time (1, 4 and 7 min) were chosen as observation levels and 12 randomizd blocks were designed when the two factors were intercrossed at every level. 4 random flaps were established on each swine, in total 24 on 6 swines, The two flaps on the same side along the swine back middle line were divided into a group, and the survival length of flaps were measured 7 days after treatment. Then another 6 swine were divided into three experiment groups by the three intermittent time: 1, 4 and 7 min, and the survival length of flaps was observed. RESULTS: ①Both pressure force and pressure time had some effects on the flap survival length, but pressure force played a more important role ( P =0.0000); In the analysis of the simple effect, the flap survival length was the longest on the level with 7.5 kPa pressure force and 1 min pressure time; there was a significant positive interaction between the pressure force and the pressure time ( P =0.0003); flap surviving length in the group with 7.5 kPa was much longer than that in the control group without treatment ( P =0.0102). ②Flap survival length in three intermittent time (1, 4 and 7 min) was 9.8, 10.7 and 9.1 cm respectively. Significant difference was found between 4 min and 7 min groups. CONCLUSION: Intermittent positive pressure force can significantly increase random pattern flap survival. 7.5 kPa, 1 min pressing with 4 min interval, might be the best choice.

关 键 词：间歇式正压 外科皮瓣 压力 皮瓣成活率 

分 类 号：R622.1[医药卫生—整形外科]