预构扩张皮瓣的形态学观察

目的观察兔股动静脉血管束预构扩张皮瓣的成活及光镜、电镜的形态学结构改变。方法30只健康成年雄性新西兰兔随机分为A，B，C3组，每组10只，A组为实验组，B，C组为对照组。将各组新西兰兔股动静脉血管束移位后，A组在肉膜深面植入50ml扩张器，1周后开始注水扩张；B组仅在肉膜深面植入50ml扩张器不注水扩张；C组则单纯股动静脉血管束预构。定期对3组皮瓣取样进行光镜及电镜观察。第57天A组扩张完成后，3组分别形成仅以预构股动静脉血管束为蒂的岛状皮瓣，原位缝合后1周观察记录3组皮瓣成活面积并取样进行光镜及电镜观察。结果A组岛状皮瓣成活面积明显大于B，C组（P〈0．05）。预构术后57d，光镜观察3组血管分布密度均增高，A组密度大于B，C组；电镜观察3组毛细血管内皮细胞的胞体、胞核明显增大，胞浆内粗面内质网、线粒体及质膜小泡明显增多，A组较B，C组明显。结论扩张术能增加新生毛细血管密度，提高预构皮瓣微循环灌注，增大皮瓣成活面积，从而提高皮瓣移植的安全性。

Morphologic Observation of Expanded Prefabricated Flaps

Objective To observe the surviving area and morphologic structural changes of expanded prefabricated flaps. ods Thirty New Zealand male rabbits were randomly divided into three groups, each group consisting of 10 rabbits：group A, experiment group;group B and group C ,control groups. After the femoral vascular bundles were transplanted into subcutaneous tissues of abdomen, expanders were implanted into the deeper dartos in group A and group B. For group A,the expansion was carried out at 7 days postoperatively. After 57 days,when the expander was fully expanded,island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by digital recording of survival area, light microscope and electron microscope. Results When compared with group B and group C ,flaps survival improved;blood capillary were stronger, the blood flow enhanced;together with ultrastructural changes were significant in group A. Conclusion Expensian can enhance the microcirculation of prefabricated flaps,increase the survival size of the flaps and the safety of flap transplantation.