大鼠隐血管束全腹壁预制皮瓣模型的实验研究

目的:探讨一种以大鼠隐血管束为预制血管蒂的全腹壁预制皮瓣模型的设计及应用价值。方法:将18只SD大鼠按Ⅰ期手术与Ⅱ期手术之间的间隔时间2、4、6周分为三组。Ⅰ期手术制备大鼠后肢隐血管束预制血管蒂,Ⅱ期手术切开皮瓣四边,形成以预制隐血管束为蒂的岛状皮瓣。Ⅰ期、Ⅱ期术后观察皮瓣血运,记录皮瓣成活面积及成活率。检测Ⅱ期皮瓣血管蒂旁局部组织中血管内皮生长因子(VEGF)含量,取成活皮瓣制作病例切片,HE染色,计算血管密度(血管数/mm2)。运用统计学方法比较各组间差异。结果:Ⅰ期术后各组大鼠腹部皮瓣全部成活;Ⅱ期术后1周,Ⅰ组皮瓣全部坏死,Ⅱ组、Ⅲ组皮瓣平均成活率分别为(14.68±1.02)%,(16.19±1.71)%(P<0.05);Ⅱ期皮瓣局部组织VEGF平均含量:Ⅰ组243.95±4.37,Ⅱ组240.89±3.11,Ⅲ组239.19±2.61(P>0.05);大鼠平均血管密度6周组较4周组略有增多,但差别不大(P>0.05)。结论:大鼠隐血管束全腹壁预制皮瓣模型,可以作为研究提高预制皮瓣成活率的基础,Ⅰ期手术与Ⅱ期手术之间的时间间隔至少需4周。

An experimental study of rat abdominal flap prefabrication model with saphenous bundle

Objective To explore the design and value of a rat abdominal flap prefabrication model with saphenous bundle.Methods 18 SD rats were divided into 3 groups by different intervals(2,4,6 weeks) between the first and second surgery stages.In the first stage,the right saphenous bundle was prefabricated as the vascular pedicle.In the second stage,the abdominal island flap with the prefabricated pedicle was elevated.The postoperative neovascularisation level was assessed by viable rate,VEGF level of flap tissues and vascular density under high power microscope.Statistical methods were used to compare the differences among the 3 groups.Results: Flaps of 3 groups after first stage were all viable.1 week after second stage,all flaps of Group Ⅰ were necrotic,the mean viable rate of Group Ⅱ and Ⅲ were(14.68±1.02)% and(16.19±1.71)%,respectively(P<0.05).The mean VEGF level of 3 groups were 243.95±4.37,240.89±3.11 and 239.19±2.61,respectively(P>0.05).The mean vascular density of Group Ⅲ was a little higher than Group Ⅱ(P>0.05).Conclusion: The rat abdominal flap prefabrication model with saphenous bundle is an available model for research of flap prefabrication.And the interval between two surgery stages should be 4 weeks at least.