岛状皮瓣静脉淤血再通后对大鼠全身情况的影响  

Systemic influence after an island flap with venous congestion-reperfusion injury

作　　者：曹景敏[1] 鲁开化[1] 王标[2] 郭树忠[1] 

机构地区：[1]第四军医大学西京医院整形外科中心 [2]济南军区总医院整形外科

出　　处：《中华整形外科杂志》2003年第1期21-23,共3页Chinese Journal of Plastic Surgery

摘　　要：目的　探讨岛状皮瓣静脉淤血再通后对全身多脏器的影响。方法　按静脉淤血时间的不同将大鼠分为 4组。观察耳部微循环的改变 ,测量术后肿瘤坏死因子α(TNFα) ,白细胞介素 10(IL 10 )的动态变化 ,观察心 ,肺 ,肝 ,肾 ,小肠及耳部血管等组织结构及中性粒细胞浸润数目。结果　皮瓣原位缝合组及静脉淤血 2h组 ,耳部微循环、TNFα、IL 10浓度基本保持不变 ,各脏器结构改变较轻 ,中性粒细胞浸润数目少。静脉淤血 6、10h组 ,微循环 ,肺 ,小肠 ,血管则有明显组织学改变 ,大量中性粒细胞浸润其中 ,但心 ,肝 ,肾组织学改变较轻。TNFα浓度再灌注 1h达到高峰 ,其后逐渐下降 ,IL 10浓度 3h达到最低 ,然后逐渐上升。结论　皮瓣静脉淤血再通后可造成肺、小肠及血管器官损伤 ,静脉淤血时间越长 ,再通后则损伤程度越重。全身微循环的改变 ,中性粒细胞在肺、小肠中的浸润 ,与血管内皮细胞的粘附及细胞因子TNFα与IL 10的浓度失衡是重要的操作原因。ObjectiveTo investigate the systemic influence after an island flap with venous congestion-reperfusion. Methods An island flap was formed in a Rat model. The vein in the pedicle was clamped for 2 hours, 6 hours and 10 hours and released. The ear microcirculation, levels of TNFα and IL-10 were measured, and the neutrophils sequestration in tissues were counted. The vascular structure of the lung and intestine were evaluated. Results There were significant changes in the ear microcirculation, neutrophils sequestration of the lung and the intestine in the 2 hours, 6 hours and 10 hours groups, and became more serious by the time increasing. The TNFα level reached in maximum at 1 hour after the reperfusion, while the IL-10 became to the lowest level at 3 hours after the reperfusion. However, the TNFα and IL-10 levels were significant high in the 6 hour and 10 hours groups, compared with the 2 hours group and the control, but there was no differences between the2 hours group and the control. Conclusions Venous congestion-reperfusion of flap could injury the remote organs such as lung, intestinal etc. The injury could be more serious with the time increasing.;

关 键 词：岛状皮瓣 静脉淤血 皮瓣静脉淤血再通 多脏器损伤 皮瓣移植 

分 类 号：R363[医药卫生—病理学]