高压氧预处理促进皮瓣成活的研究

目的探讨高压氧（hyperbaric oxygen，HBO）预处理对提高皮肤缺血耐受的作用。方法18只雄性SD大鼠分为HB0预处理组和对照组。HBO预处理组大鼠在手术前2d行HBO治疗，对照组大鼠不做任何处理。麻醉后在大鼠腹部形成以右侧腹壁下浅动脉为蒂的扩大腹部皮瓣，大小约6cm×9cm。先用显微血管夹阻断皮瓣血供3h，然后恢复皮瓣血供。术后第5天观察皮瓣成活情况。用硫酸纸按设计皮瓣和成活皮瓣形状剪成相应的纸模并用扫描仪将纸模转换为相应的皮瓣图像。用Acrobat软件计算分析皮瓣面积。数据用SPSS软件进行统计学分析。结果对照组和预处理组的平均皮瓣设计面积分别为（51．59±6．62）cm^2和（52．71±2．05）cm^2。平均成活面积分别为（7．38±2．49）cm^2和（15．82±5．95）cm^2。两组在皮瓣成活面积上差异有统计学意义（t=4．14，P〈0．01）。结论HBO预处理能提高皮肤缺血耐受，提高皮瓣成活率。

Hyperbaric oxygenation preconditioning induces skin flap ischaemia tolerance in a rat model

Objective To study the effect of preconditioning hyperbaric oxygenation on skin flap is-ehaemia tolerance. Methods 18 male SD rats were divided into the control and HBO preconditioning groups. In control group, an extended epigastrie adipocutaneous flap was raised, based on the right su-perficial epigastric artery and vein. 3-hours flap ischemia was induced by clamping the pedicle vessels with microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was sutured back. Rats in HBO preconditioning group were treated with HBO two days before operation. Flap surger-y began 1 hour after the last HBO treatment. The operation was the same as the control group. On the fifth postoperative day, the condition of the flap was recorded with transparent paper. Mean flap necrosis area was calculated with Acrobat software. Data were analyzed with SPSS software. Results The aver-age designed flap area was (51.59±6.62)cm2 and (52.71±2.05)cm2 in the control group and the HBO preconditioning group. The average flap survival area was (7.38±2.49)cm2 and (15.82±5.95)cm2. The difference was significant between the control and HBO preconditioning groups (t= 4. 14, P<0.01) in average flap survival area. Conclusion HBO preconditioning can rise flap ischaemia tolerance and enhance flap survival.