随意皮瓣血流动态变化的实验研究

目的 通过激光多普勒血液灌流成像仪对随意皮瓣血流变化的实验研究,了解皮瓣血运的建立及断蒂时机的选择.方法 成年健康大耳白兔20只,以每5只家兔单侧皮瓣为一组,分别在术后1、3、5、7、9、12、14、18 d断蒂,时皮瓣远端及蒂部两端中点在断蒂前进行血液灌流(PU)值测量,对所得PU值进行统计学分析.结果 术后不同时间皮瓣蒂部的PU值变化不大(P均＞0.05).皮瓣远端的PU值在皮瓣术后1 d最低为(0.68±0.09),后逐渐增高,术后3 d(1.24±0.07),术后5 d(1.57±0.15),术后7 d(1.79±0.08),术后9 d(1.89±0.13),术后12 d(2.01±0.16),术后14 d(2.18±0.09),术后18 d(2.40±0.18),差异均有统计学意义(P均＜0.05).皮瓣远端PU值与皮瓣蒂部PU值比值在≥1.2时,皮瓣断蒂后成活比率达99%.结论 实验中发现随意皮瓣血液循环的建立,以及皮瓣远端PU值与皮瓣蒂部PU值的比值可作为皮瓣断蒂时机选择的重要检测指标.

Random flap experimental study of dynamic changes of blood flow

Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P＞0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P＜0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.