隐匿型穿支皮瓣动物模型血流动力学的初步研究  

A preliminary study of the hemodynamics of concealed perforator flap in animal model with ultrasonic Doppler technique

作　　者：詹翼 周翔[2] 梁晶 李旭博 李雯雯[3] 杨宇童 潘福顺[4] 戚剑[2,5] ZHAN Yi;ZHOU Xiang;LIANG Jing;LI Xubo;LI Wenwen;YANG Yutong;PAN Fushun;QI Jian(Department of Orthopaedics,Affiliated Hospital of Guilin Medical University,Guilin Guangxi,541001,P.R.China;Department of Microsurgery and Orthopedic Trauma,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong,510080,P.R.China;Laboratory Animal Center,the First Afiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong,510080,P.R.China;Department of Ultrasound,the First Afiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong,510080,P.R.China;Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology,Guangzhou Guangdong,510080,P.R.China)

机构地区：[1]桂林医学院附属医院骨科,广西桂林541001 [2]中山大学附属第一医院显微创伤手外科,广州510080 [3]中山大学附属第一医院动物实验中心,广州510080 [4]中山大学附属第一医院超声科,广州510080 [5]广东省骨科重点实验室,广州510080

出　　处：《中国修复重建外科杂志》2023年第1期46-51,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：广西科技基地和人才专项(桂科AD20238073);广东省基础与应用基础研究基金(2022A1515012466)。

摘　　要：目的 应用多普勒超声对小型猪隐匿型穿支皮瓣血流动力学进行初步研究。方法 取7月龄普通级广西巴马实验小型猪7只,体质量20~25 kg,于双侧后肢分别制备隐动脉穿支皮瓣(A组,n=4)、隐动脉隐匿型穿支皮瓣(B组,n=5)、隐动脉隐匿型穿支皮瓣+肌膜(C组,n=5)。术后观察实验动物存活以及皮瓣成活情况,术后5 d皮瓣拍照后采用Photoshop CS5软件计算皮瓣成活面积百分比。于术前及术后即刻、3 d、5 d对皮瓣进行多普勒超声检测,其中隐动脉指标包括内径、收缩期峰值流速、阻力指数、血流量,隐静脉指标包括内径、最大流速、血流量,记录皮瓣血流动力学变化情况。结果 术后1 d,1只实验动物因感染死亡,其余实验动物均存活至实验完成。最终A组3侧、B组4侧、C组5侧后肢皮瓣纳入观测。术后3组皮瓣均出现肿胀,3 d时最显著,且B组皮瓣出现部分瘀紫和坏死;5 d时,A、C组皮瓣基本成活,B组皮瓣坏死面积进一步增大,A、B、C组皮瓣成活面积百分比分别为99.7%±0.5%、74.8%±26.4%、100%,B组低于A、C组(P<0.05),A、C组间差异无统计学意义(P>0.05)。3组组内各时间点皮瓣隐动、静脉血流动力学指标比较,差异均有统计学意义(P<0.05);各时间点组间比较,差异均无统计学意义(P>0.05)。结论 多普勒超声监测初步研究显示单纯隐动脉隐匿型穿支皮瓣及联合肌膜两种皮瓣类型均有稳定血流,但后者皮瓣成活面积优于前者。Objective To study the hemodynamic characteristics of concealed perforator flap in mini-pigs by ultrasonic Doppler technique. Methods Seven 7-month-old mini-pigs, weighing 20-25 kg, were included in the study.The saphenous artery perforator flap(group A, n=4), saphenous artery concealed perforator flap(group B, n=5), and saphenous artery concealed perforator flap combined with sarcolemma(group C, n=5) models were established randomly on both hind limbs of pigs. The pigs and flap survival conditions were observed after operation. The percentage of flap survival area was calculated by Photoshop CS5 software at 5 days after operation. Ultrasonic Doppler technique was performed on the flaps before operation and at immediate, 3 days, and 5 days after operation to record the hemodynamic changes of the flaps. The hemodynamic indicators of saphenous artery(inner diameter, peak systoli velocity, resistance index, and blood flow) and saphenous vein(inner diameter, maximum velocity, and blood flow) were recorded. Results At 1 day after operation, 1 pig died of infection, and the rest survived until the experiment was completed. Finally, the3 flaps of group A, 4 of group B, and 5 of group C were included in the study. The flaps of the 3 groups all showed swelling after operation, which was most significant at 3 days. At 3 days after operation, the flaps in group B showed partial bruising and necrosis. At 5 days after operation, the flaps in groups A and C were basically alive, and the necrosis area of flap in group B increased further. The percentage of flap survival area in groups A, B, and C were 99.7%±0.5%,74.8%±26.4%, and 100%, respectively. The percentage of flap was significantly lower in group B than in groups A and C(P<0.05). There was no significant difference between groups A and C(P>0.05). There were significant differences in the hemodynamic indicators of saphenous artery and vein between different time points in 3 groups(P<0.05). There was no significant difference in each indicator between groups at each time

关 键 词：隐匿型穿支皮瓣 隐动脉 血流动力学 多普勒超声 猪 

分 类 号：R-332[医药卫生]