撕脱皮瓣血液循环判断方法的实验研究  

Comparison study of the techniques for the predict of the blood perfusion of avulsion skin flap in pig

作　　者：郭树忠[1] 鲁开化[1] 张琳西[1] 易成刚[1] 

机构地区：[1]第四军医大学西京医院整形外科中心,陕西西安710032

出　　处：《中国实用美容整形外科杂志》2004年第2期59-62,共4页

基　　金：国家自然科学基金资助项目 ( 3 9470 70 5 )

摘　　要：目的　研究撕脱皮瓣血液循环的判断方法 ,为临床处理皮肤撕脱伤提供理论依据。方法　利用自行研制的皮肤撕脱伤模型机 ,在猪的一侧后肢形成面积为 4cm× 10cm的撕脱皮瓣 ,对侧肢体的相应部位形成相同面积的常规皮瓣作为对照 ,皮瓣形成后 1h测定皮瓣表面温度和激光多普勒指数 ,并从静脉注射荧光素钠用长波 (36 0～4 0 0nm)紫外检测灯观察皮瓣表面的荧光 ,7天后用计算机图像处理系统测算皮瓣成活面积。结果　撕脱皮瓣较常规皮瓣成活面积少 33.16 %。撕脱皮瓣形成后从近端至远端表面温度逐渐下降 ,激光多普勒指数逐渐降低 ,当温度下降超过 2 .4℃、激光多普勒指数下降超过 4 9.80 %时 ,撕脱皮瓣实际成活面积较荧光预测的少 8.5 1% ,撕脱皮瓣有继发性坏死发生。结论　荧光法对皮瓣血液循环的判断及成活面积的预测其结果易得并且比较直观 。Objective To investigate the techniques for predict of the blood perfusion of the tissue in skin avulsion injury. Methods A machine was developed to mimic traffic accident and to create an avulsion injury pattern in hind leg of pig. A 4?cm×10?cm random avulsed skin flap was created in the avulsion area. Thermometer, laser Doppler blood flow-meter and fluorescein were adopted to measure the blood perfusion in avulsion skin flap. Results When surface temperature of the avulsion skin flap descended 2.4?℃, Doppler index was lower than 49.80%, the avulsed flap would become necrosis. The real survival area of avulsed skin flap was 8.51% less than what was predicted with fluorescein. There was secondary necrosis happened in avulsed skin flaps. The survival area of avulsed skin flap was 33.16% less than that of same size normal skin flap. Conclusion The fluorescein is a nice technique to predict blood perfusion if it was used with other techniques.

关 键 词：撕脱皮瓣 血液循环 皮肤撕脱伤 创伤 治疗 

分 类 号：R622.1[医药卫生—整形外科]