扩张皮肤血液动力学及皮瓣移植实验研究  

The study for the hemodynamics of expansive skin and the transplant time of skin flap designed by expansive skin

作　　者：邱玉金[1] 唐胜建[1] 逄迎春[2] 

机构地区：[1]潍坊医学院整形外科医院整形外科教研室,261042 [2]潍坊市人民医院

出　　处：《中华外科杂志》2002年第1期20-23,共4页Chinese Journal of Surgery

摘　　要：目的　研究扩张皮肤血液动力学变化规律 ,探索将扩张皮肤设计成任意皮瓣进行皮肤移植的最佳时机。方法　以 72只兔耳为活体实验标本 ,应用微循环显微图像计算机分析系统、酶组织化学染色和多功能真彩色病理图像分析技术 ,观测不扩张对照耳 (n =8)皮肤与处于不同扩张时间的扩张组 (n =8× 8)皮肤内微血管直径、密度、血流速度、血流量等指标值 ,并将扩张皮肤设计成任意皮瓣移植 ,测量皮瓣成活部分的长宽比例和面积。结果　 ( 1)扩张皮肤微血管直径 ( 13 4 3± 0 98)μm、密度 ( 0 0 4 72± 0 0 0 2 2 )、血流速度 ( 10 12 70± 65 5 1) μm/s、血流量 ( 14 71± 0 74 ) μm3/s ,较对照皮肤 [(分别是 ( 7 2 2± 0 71) μm、( 0 0 10 8± 0 0 0 0 2 )、( 3 2 7 0 1± 65 5 1) μm/s、( 1 4 6± 0 4 1) μm3/s]明显增大变快 ,差异有显著意义 (t=6 4 9～ 4 9 4 9,P均 <0 0 1)。 ( 2 )扩张过程中 ,血流速度加快并一直维持在较高水平 ;血管直径和血流量每 4周有 1次周期性变化 ,每 1周期的第 3周末均出现一增量峰值 ,后一周期的变化是在前一周期增量基础上的进一步增大 ;血管密度也呈周期性变化 ,但各周期间密度变化范围相同。 ( 3 )每一变化周期第 3周末的扩张皮肤设计成任意皮瓣移植 。Objective To study the change rule of the hemodynamics of expanded skins and research the transplant time of random pattern flaps that are made of the expanded skin. Methods 72 ears of 64 rabbits were used as a subject of experiment.Four items of the contrasted skin( n =8) and expanded skin( n =8×8),Which include the microvessel diameter,the microvessel density,the blood velocity and the blood volume, were observated and mearured by the microcirculatory imaging computer analysis system,the enzyme histochemical dyeing and the more functions colored pathological imaging computer analysis system. The length width proportion and the largest area of the flaps that had made of the expansive skin and survived were measured. Results (1)The four items of expanded skin,that the microvessel diameter,the microvessel density,the blood velocity and the blood volume are 13 43±0 98 μm?0 047 2±0 002 2?1 012 70±65 51 μm/s?14 71±0 74 μm 3/s respectively, are much biger or quicker than those of contrasted skin[(7 22±0 71)μm?0 010 8±0 000 2?(327 01±65 51) μm/s?(1 46±0 41) μm 3/s] and there is the significant defference between both( t =6 49～49 49, P <0 01) (2)The blood velocity increases in the expanding phases and always keeps on higher level. The other items all change periodically. Span of the period is four weeks.The microvessel diameter and the blood volume have a peak value at third weekend of every period and in the later period enhance more on the basis of the former period. The microvessel density changes in definite range in every period.(3)The surviving area of the random skin flaps is the largest which were made of the expanded skin in third weekend of every period,it channgs more than those of other weekends in same period and later period is superior to the former period.There is a significant defference compared with contrasted random skin flaps ( q =3 721 5, P <0 05; q =5 502 6, P <0 01). Conclusion The hemodynamics of the expanded skin chang

关 键 词：外科皮瓣 血液动力学 皮肤移植 微血管显微镜检查 动物实验 

分 类 号：R622[医药卫生—整形外科]