影响皮瓣存活的相关机制研究进展  

Progress on the Main Mechanism Affecting Flap Survival

作　　者：李金鹏[1] 郭婕[2] 刘涛 魏晓涛 宋渊[3] 王威威 何志军[1] LI Jinpeng;GUO Jie;LIU Tao;WEI Xiaotao;SONG Yuan;WANG Weiwei;HE Zhijun(Foot and Ankle Orthopedics,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China;Nursing Department,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China;Second Department of Hand Surgery,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China;College of Clinical Chinese Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃省中医院足踝骨科,兰州730000 [2]甘肃省中医院护理部,兰州730000 [3]甘肃省中医院手外二科,兰州730000 [4]甘肃中医药大学中医临床学院,兰州730000

出　　处：《协和医学杂志》2025年第2期416-422,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：国家自然科学基金(81660802,81860863,82460942);中共甘肃省委组织部省级青年人才项目(甘组通字[2024]4号);甘肃省自然科学基金(22JR5RA620);甘肃省中医药管理局高水平重点课题(GZKZ-2024-3);甘肃省重点研发计划(21YF5FA021);兰州市人才创新创业专项(2019-RC-63)。

摘　　要：皮瓣手术是一种复杂的外科手术,可用于诸多疾病和创伤的治疗。皮瓣存活与细胞自噬、氧化应激、炎症反应、间充质干细胞功能以及血管再生等多种因素密切相关。其中,细胞自噬可维持细胞内稳态,在减轻氧化应激和炎症反应、促进损伤修复等方面发挥关键作用,过度氧化应激和炎症反应会对皮瓣构成威胁,影响其存活和成功移植;内皮细胞通过增殖、迁移和产生血管生成因子参与血管再生,而血管内皮生长因子则可直接促进血管形成和维持内皮细胞功能;间充质干细胞具有独特的生物学特性和多种作用机制,在促进皮瓣存活和组织修复中发挥重要作用。本文阐述细胞自噬、氧化应激、炎症反应、间充质干细胞功能以及血管再生影响术后皮瓣存活的作用机制,以期为提高术后皮瓣存活率提供依据。Flap surgery is a complex surgical procedure that has become an effective method for the treatment of many diseases and traumas.Flap survival is closely related to a variety of factors including cellular autophagy,oxidative stress,inflammatory response,mesenchymal stem cells(MSCs)function,and vascular regeneration.Cellular autophagy maintains intracellular homeostasis and plays a key role in reducing oxidative stress and inflammation and promoting injury repair.Excessive oxidative stress and inflammatory responses pose a threat to flaps,affecting their survival and successful transplantation.Endothelial cells are involved in vascu⁃lar regeneration through proliferation,migration,and production of angiogenic factors,and vascular endothelial growth factor directly promotes blood vessel formation and maintains endothelial cell function.MSCs play an important role in promoting flap survival and tissue repair due to their unique biological properties and multiple mechanisms of action.The multiple roles played by cellular autophagy,oxidative stress,inflammatory response,MSCs function,and vascular regeneration in influencing postoperative flap survival are hereby elaborated.The aim is to provide a basis for the clinical application of regulating the above factors to improve postoperative flap survival,improve the success rate of flap surgery,reduce complications,and bring more hope for the recovery and quality of life of patients.

关 键 词：皮瓣 炎症反应 氧化应激 细胞自噬 细胞凋亡 间充质干细胞 血管再生 

分 类 号：R61[医药卫生—外科学] R392[医药卫生—临床医学]