兔耳远端蒂浅静脉-耳大神经营养血管皮瓣的研究

目的探讨浅静脉干对远端蒂耳大神经营养血管皮瓣成活的影响。方法以30只日本大耳白兔作为实验对象随机分为3组：Ⅰ组静脉-神经组、Ⅱ组神经组及Ⅲ组对照组。另外2只日本大耳白兔作为实验对照。于兔耳根部中央区设计远端蒂皮瓣1．2cm×3．8cm，Ⅰ组保留静脉和神经；Ⅱ组保留神经；Ⅲ组动、静脉和神经均不保留，皮瓣制备完成后即刻原位缝合。术后1h对3组皮瓣进行组织学观察并测定皮瓣的丙二醛（MDA）含量。术后1周，测量3组皮瓣的成活面积。结果术后1h，各组皮瓣均出现不同程度的出血和水肿，其中Ⅰ组反应相对较轻；MDA含量Ⅰ组与Ⅱ组间没有显著性差异，Ⅰ组与Ⅲ组、Ⅱ组与Ⅲ组间有显著性差异。术后1周，各组皮瓣的成活率以Ⅰ组最高。结论保留浅静脉干没有增加兔耳远端蒂耳大神经营养血管皮瓣的回流负荷，对皮瓣的成活有利。

The Experimental Study of Distally Based Greater Auricular Veno neurocutaneous Flap in Rabbits

Objective To explore the influence of the superficial venous trunks in the survival of the distally based greater auricular veno-neurocutaneous flap. Methods 30 rabbits were used as the experimental model. 60 ears were divided into three groups randomly： group Ⅰ -distally based greater auricular veno-neurocutaneous flap; group Ⅱ -distally based greater auricular neurocutaneous flap; group Ⅲ- random pattern flap. 2 rabbits were used as the control. A distally based flap （ 1.2cm × 3.8cm） was designed in the rabbit. The vein and the great auricalar nerve were protected in group Ⅰ . The great auricalar nerve was protected in gronp Ⅱ. The central artery, vein ant the great auricular nerve were wot protected in group Ⅲ. Then all flaps were sutured in situ. In the first postoperative hour, the flaps were observed in histopathology and the content of MDA was measured. On the seventh postoperative day, the survival areas in the flaps were measured. Results In the first postoperative hour, there were bleeding and edema in all flaps. The responses in group Ⅰ were relatively lighter. There was no significant difference in the contents of MDA between groups Ⅰ and Ⅱ. There was significant difference in the contents of MDA between groups Ⅰ and Ⅲ, and between groups Ⅱ and Ⅲ. On the seventh postoperative day, the rate of the survival areas in group Ⅰ was the highest. Conclusion Retaining the superficial venous trunks dose not increase the backflow load in the distally based greater auricular neurocutaneous flap, it is advantageous for the survival of the flap.