低分子右旋糖酐与盐酸罂粟碱对皮瓣成活质量影响的实验研究

目的 观察低分子右旋糖酐和盐酸罂粟碱对游离皮瓣血流通畅和成活质量的影响.方法 选用中国家兔48只,随机分为4组,每组12只.A组：对照组;B组：盐酸罂粟碱治疗组;C组：低分子右旋糖酐治疗组;D组：盐酸罂粟碱和低分子右旋糖酐联合治疗组.行兔耳游离皮瓣移植术.每只家兔术后行大体观察,组织学观察,微血管密度测定,皮瓣组织中丙二醛（malondialdehyde,MDA）检测,透射电镜观察动脉吻合口超显微结构.结果 各观察指标显示B,C,D组皆优于A组,B,D两组无明显差异,皆优于C组.结论 术中术后应用盐酸罂粟碱可有效防止血管痉挛,维持血流通畅,促进微血管生成,增强抗再灌注损伤能力,提高游离皮瓣成活质量;低分子右旋糖酐单独应用对维持游离皮瓣血流通畅和促进微血管生成等效果不明显.

Animal Study on the Effects of Application of Dextran 40 and Papaverine on Flap Quality

Objective To investigate the effects on application of dextran 40 and/or papaverine in free flap transfer. Methods In this study, 48 Chinese rabbits were divided into 4 groups with each group of 12, group A （control group）, B （papaverine）, C（ dextran 40）, and D （both dextran 40 and papaverine）. Free flap transfer was performed at the rabbit ear. After operation, observation of flap appearance and survival, growth of granulation tissues and capillary under microscope, measurement of content of malondialdehyde （MDA） in the flap tissues, and observation of the anatomized site of the vessel under electron microscope were performed. Results The results showed that the values of group B, C, and D were all superior to those of group A with statistically significant. The statistics showed that there was no significant difference between the values of group B and D. The results also showed that the values of group B and D were all superior to those of group C. Conclusion Intraoperative and postoperative application of dextran 40 and/ or papaverine shows benefits in flap survival by the means such as prevention of vasospasm, promotion of blood supply and capillary growth, and inhabitation of ischemia-reperfusion injury, etc. However, sole application of dextran 40 shows no obvious benefit.