阻隔皮瓣内葡萄糖、乳酸的代谢变化

新西兰兔42只，随机分为正常、即刻、阻隔延迟1、4、7、21天共7组。观察阻隔皮瓣在超长宽比（10:1）存活时，皮瓣组织内乳酸（Lac）葡萄糖（Glu）的代谢变化。阻隔延迟皮瓣断远端蒂后，测定各组皮瓣蒂部、末端及中部3点的Glu、Lac及经皮氧分压（PtcO2）值。结果表明，阻隔皮瓣在延迟过程中PtcO2值始终低于正常，其组织内Glu水平逐渐下降，Lac升高。7天后皮瓣存活长度逐渐增加，各部位Glu、Lac差别较大，而14天后各部位值相近；21天后皮瓣Glu极低，Lac很高，但皮瓣全部存活。结果提示，皮瓣经阻隔延迟后对缺氧逐渐耐受，处于低氧低代谢状态。在此状态下皮瓣能存活，是由于组织细胞产生的一些细胞保护因子，维持细胞存活。阻隔皮瓣最低存活值Glu 0.01mmol/L,Lac0.47mmol/L,经皮氧分压值为3mmHg。

EXPERIMENTAL OBSERVATION FOR METABOLIC CHANGES IN GLUCOSE AND LACTIC ACID IN BIPEDICLED SEPARATION DELAYED FLAP

Bi-polar,bi-pedicled separation delayed flaps were designed on the backs of New Zealand rabbits with the application of a medical silicon membrane as the separation material. Values of glucose and lactic acid, PtcO 2 were measured separately at proximal,middle and distal areas of the flaps after the distal pedice was cut at 0,1,4,7,14,21 days,respectively, after the formation of flaps. After flap delaying,PtcO 2 in separated flap was always lower than that of the mormal control,accompanied with glucose decrease and lactic acid increase, although there were significant differences in different areas of the flap. The survived area of the flap increased after 7 days. Furthermore,all the length of the flap survived after 21 days,although the level of glucose in the flap was still lower and lactic acid was still higher.The results suggested that by separation and delaying the flap may adapt gradually to hypoxia via lowered metabolism.For flap survival,the threshold value of glucose in flap is 0 01mmol/L , lactic acid is 0 47mmol/L,and PtcO 2 is 3mmHg .