VEGF促进预构皮瓣血管新生的实验研究

目的探讨VEGF重组蛋白促进大鼠预构皮瓣血管新生、提高皮瓣存活面积的可行性。方法建立大鼠腹部预构皮瓣模型；30只Wistar大鼠随机分为两组；局部应用VEGF165（组Ⅰ）、PBS（组Ⅱ）；4周后形成以植入血管为蒂的岛状皮瓣，原位缝合；术后7d对皮瓣存活、血管新生情况进行检测。结果组Ⅰ、组Ⅱ的皮瓣存活率分别为66．13％±9．9％，55．59％±13．06％（P〈0．05）；组Ⅰ与组Ⅱ比较，微血管显影血管网更丰富，范围更广，分支更粗，内含墨汁的血管在皮瓣的表皮真皮、皮下层均有分布；微血管计数组Ⅰ、组Ⅱ分别为25．83±6．33条／mm^2，26．5±5．61条／mm^2（p〉0．05）。结论VEGF可以促进预构皮瓣的血管新生，提高存活率。

An Experimental Study of VEGF Increasing Neovascularization of Prefabricated Flap

Objective To investigate the feasibility of locally administration of VEGF to increase neovascularization and improve the survival areas in a rat model of prefabricated flap. Methods Prefabricated Flaps were generated by ligating the right femoral vascular pedicle and implanting them underneath the abdominal flaps. 30 rats were randomly divided into two groups equally. The implantation site around the pedicle was injected with VEGF 165 in group Ⅰ, and with PBS in control group Ⅱ. Four weeks later, an abdominal island flap based solely on the implanted vessels was elevated. The prefabricated island flap was sutured back, then neovascularization and flap viability was evaluated on day 7. Results There was a significant increase in survival of prefabricated flaps in group I compared with group Ⅱ ： VEGF 165 66.13 % ± 9.9 % vs. PBS 55.59 % ± 13.06 % （p〈0.05）. In group Ⅰ, vascularization demonstrated by microangiography was distributed in a larger area compared with group Ⅱ. The microvessel with ink stained located in epidermis, dermis, subcutaneous. The capillary density of two groups were respectively 25.83 ± 6.33, 26.5 ± 5.61 capillary/mm^2 （p 〉0.05）. Conclusion Locally administration of VEGF can increase neovascularization and improve the survival areas of prefabricated flaps.