保留穿支蒂皮瓣筋膜组织对大鼠背部皮瓣成活影响的实验研究  

The effect of fascial tissue preservation of perforator pedicle flap on the survival of rat dorsal flap

作　　者：朱文静 王瑜[1] 李心怡[1] 李小静[1] ZHU Wenjing;WANG Yu;LI Xinyi;LI Xiaojing(Department of Plastic Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院整形外科,安徽合肥230022

出　　处：《中国美容整形外科杂志》2023年第3期149-152,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨保留皮瓣穿支蒂部的筋膜对大鼠背部皮瓣成活的影响,探讨血流动力学改变方式及机制。方法 自2016年1—4月,安徽医科大学第一附属医院整形外科选取30只健康SD大鼠,雌雄不限,在大鼠右侧背部建立大小为8.0 cm×2.0 cm的局部原位皮瓣模型,随机分为A、B、C 3组,10只/组。A组为穿支皮瓣组,B组为穿支筋膜蒂皮瓣组,C组为随意皮瓣组。A、B组大鼠以右侧肋间后血管为皮瓣的穿支血管。术后观察皮瓣颜色、肿胀及坏死情况,计算术后7、14 d 3组皮瓣的成活率;术后7 d内对3组皮瓣血流灌注值进行比较;术后7、14 d用明胶-氧化铅灌注进行背部皮瓣造影,观察皮瓣血管结构变化情况。结果 术后7、14 d,A、B组成活率显著高于C组,其中B组成活率高于A组,3组皮瓣成活面积比较,差异具有统计学意义(P<0.05),术后7 d与14 d比较,差异无统计学意义(P>0.05);明胶-氧化铅灌注造影显示,B组皮瓣血管真性吻合数较其他组明显增多。结论 保留皮瓣穿支蒂和周围部分筋膜比单纯保留穿支或筋膜更加有利于皮瓣成活。Objective To investigate the effect of retaining fascia on the survival of dorsal flap in rats, and to explore the hemodynamic changes and mechanisms. Methods From January 2016 to April 2016, 30 healthy SD rats were selected from Department of Plastic Surgery of The First Affiliated Hospital of Anhui Medical University. A local in situ flap model with a size of 2.0 cm×8.0 cm was established on the right back of the rat, randomly divided into 3 groups A, B and C with 10 rats in each group. Group A was the perforator pedicle flap group, group B was the perforator fascial pedicle flap group, group C was the random flap group. In group A and B, the right posterior intercostal vessel was used as the perforating vessel of the flap. The skin flap color, swelling and necrosis were observed postoperatively,and the survival rate of the three groups was calculated at 7 and 14 days postoperatively. The blood perfusion values of the three groups were compared within 7 days after the operation. Back flap angiography was performed by gelatin-lead oxide perfusion to observe the vascular structure of the flap at 7 and 14 days postoperatively. Results Seven and 14 days after the operation, the survival rate of groups A and B was significantly higher than that of group C, and the survival rate of group B was higher than that of group A(P<0.05). There was no statistical significance between 7 and 14 days after surgery(P>0.05), gelatin-lead oxide perfusion angiography showed that the number of true vascular anastomoses in group B was significantly higher than that in other groups. Conclusion Reserving the perforator pedicle and surrounding fascia of the flap is more beneficial to the survival of the flap than reserving the perforator or fascia alone.

关 键 词：大鼠 穿支皮瓣 筋膜 激光多普勒 

分 类 号：R622[医药卫生—整形外科]