激光多普勒对大鼠背部3种皮瓣模型的血流动力学特点研究

目的　利用激光多普勒对大鼠背部3种皮瓣的血流动力学特点进行研究。 方法　30只雄性SD大鼠，按照皮瓣切取方式等分为3组：穿支皮瓣组、穿支筋膜蒂皮瓣组及随意皮瓣组。采用激光多普勒血流仪对以上3组皮瓣的Ⅰ、Ⅱ与Ⅲ区在多个时间点进行测量。术后7 d，对皮瓣外观及髂腰动脉与骶尾部穿支血管间的筋膜血管网进行拍照。对3组大鼠的坏死率，及穿支皮瓣与穿支筋膜蒂皮瓣Ⅰ、Ⅱ及Ⅲ区术后即刻、术后1 d的血流灌注值进行统计学比较。 结果　穿支皮瓣、穿支筋膜蒂皮瓣及随意皮瓣的坏死率分别为0.087±0.07、0.071±0.05及0.267±0.11。3组皮瓣坏死率有极显著统计学差异，但穿支皮瓣与穿支筋膜蒂皮瓣的坏死率差异无统计学意义。术后即刻穿支皮瓣Ⅰ区与Ⅱ区的血流灌注值显著大于穿支筋膜蒂皮瓣的Ⅰ区与Ⅱ区;随意皮瓣3个血管区的血流灌注值在术后7 d内均小于穿支皮瓣与穿支筋膜蒂皮瓣。术后7 d，随意皮瓣骶尾部穿支与髂腰动脉穿支间的筋膜血管网管径显著增大。 结论　穿支皮瓣与穿支筋膜蒂皮瓣存活能力无显著差异。随意皮瓣存活主要依赖于蒂部与蒂部周围潜在穿支之间筋膜血管网的扩张。

Study of hemodynamics on three different patterns of flaps on dorsum of rats

Objective　To study hemodynamic characteristics of three different patterns of flaps on the dorsum of rats. Methods　30 Sprague Dawley rat were equally divided into three groups: the perforator group, the perforator-based fasicocutaneous flap group and the random flap group. Laser Doppler flowmeter was adopted for measurement of blood perfusion on zoneⅠ、Ⅱand Ⅲ of the flaps on the three groups at the multiple time points. 7 d after surgery, photographs were taken for the flaps and the fasciocutaneous vascular network between the iliolumbar perforator and the sacrococcygeal perforator. Comparison of necrotic rates among the three groups, and comparison of perfusion values of zoneⅠ、Ⅱand Ⅲ on the perforator flap and the perforator-based fasciocutaneous flap immediately and 1d after surgery were carried out.　Results　The necrotic rates of the perforator flap, the perforator-based fasciocutaneous flap and the random flap was 0.087±0.07, 0.071±0.05 and 0.267±0.11, respectively. Immediately after surgery, the perfusion value of zoneⅠandⅡin the perforator flap group was larger than that in the perforator-based fasciocutaneous flap group with statistical significance. Perfusion value of the three zones in the random flap group was lower than their counterparts of the perforator flap group and the perforator-based fasciocutaneous flap. 7 d after surgery, the vascular network between the iliolumbar perforator and the sacrococcygeal perforator underwent tremendous enlargement in diameter.　Conclusion　There is no significant difference on the survival capacity between the perforator flap and the perforator-based fasciocutaneous flap. The survival of the random flap depends on the dilation of the vascular network between the pedicle and the nearest potential perforator.