兔同种异体颜面复合软组织瓣移植及组织瓣再血管化的研究

目的：建立兔同种异体颜面复合组织移植的动物模型,研究移植术后同种异体组织瓣的再血管化进程。方法：对日本大耳白兔和青紫蓝兔进行头颈部（主要是血管系统）解剖研究,并通过半侧颜面组织瓣的设计和移植,明确血管蒂所能营养组织块的最大范围,寻求最合适可靠的血管蒂,以最合适的血管蒂进行复合组织瓣移植。研究移植术后组织瓣的再血管化进程。结果：①兔头颈部的血管分支、走向与人相似,但颅内动脉及颅内、外动脉之间有丰富的交通吻合,结扎兔单侧颈总动脉,未引起偏瘫或死亡。②进行兔半侧颜面组织瓣移植最合适的血管蒂是颈外静脉和颈总动脉。③移植皮瓣的血管密度逐渐增加,约在术后10d达峰值,28d时移植皮瓣与受区相互吻合成网。结论：应用颈总动脉和颈外静脉为血管蒂进行兔同种异体颜面复合组织移植,可提高模型建立的成功率。移植后组织瓣与受区可达到良好的再血管化。

Composite tissue allotransplantation and revascularization of the flap composite in rabbits

PURPOSE：To investigate the process of revascularization of flap allotransplantation by establishing an experimental model of composite tissue allograft transplantation in rabbits.METHODS：Japanese white rabbits and livid blue rabbits were used for head and neck（mainly the vascular system） anatomical study.Hemifacial flap was designed and transplanted to clarify the maximum extent of tissue block supply of each vessel pedicle and find the most proper and reliable vessel pedicle,which could be used for transplantation of composite flap,and study the process of tissue revascularization after transplantion.RESULTS：The head and neck vessel branch and course of the rabbit was similar to the human beings,while the intracranial and extracranial arteries had rich traffic anastomoses.Ligating both sides of arteriae carotis communis in rabbits could not cause hemiplegia or death.The most proper vessel pedicle which could be used for rabbit hemisphere flap transplantation might be the carotid artery and jugular vein.The vascular density of transplanted flap reached the peak value after about 10 days.Transplanted flap and receptor flap zone were consistent with each other to form a network after 28 days.CONCLUSIONS：Carotid artery and jugular vein was applied as vessel pedicle to perform rabbit facial composite tissue allograft transplantation,which can simplify the microsurgical treatments and shorten the surgery time,and improve the success probability of model establishment.The allograft composite flap can achieve a good revascularization after transplantation.