大鼠腹部增压皮瓣模型中动、静脉增压作用的研究

摘要

目的 对大鼠腹部增压皮瓣模型中血流变化进行连续、动态观测,探索动脉增压、静脉增压分别在避免皮瓣远端坏死中的作用.方法 在SD大鼠腹部设计动静脉增压、动脉增压和静脉增压3种形式的增压皮瓣,采用近红外荧光血管造影技术对3种增压皮瓣模型中血流变化进行连续、动态的观测,对获得的血流变化影像视频进行比较和分析.同时另设计对照组皮瓣.结果 血管造影视频显示,静脉增压组和对照组皮瓣远端动脉灌注消失,术后出现了不同程度的远端皮瓣坏死,相对于对照组,静脉增压组皮瓣远端坏死面积明显减少.动静脉增压组和动脉增压组皮瓣远端动脉血流灌注充分,术后所有皮瓣完全成活.结论 皮瓣远端动脉灌注不足是造成皮瓣远端静脉瘀滞、坏死的主要原因,动脉增压确保皮瓣远端动脉血流的灌注,能够避免皮瓣远端坏死的发生.%Objective The study was to reveal the vascular changes in three different supercharging flap models.From this study,we want to investigate which vessel,the artery or the vein is more important in elongating perforator flap survival and why.Methods Twelve rats were divided into three experimental groups.The left side flaps in all groups were pedicle using xiphoid perforator as control group.The right side flaps were supercharging experimental group.Group Ⅰ,flap supercharged based on artery and vein of pubis perforator.Group Ⅱ,flaps supercharged based on artery of pubis perforator.Group Ⅲ,flaps supercharged based on vein of pubis perforator.Near-infrared fluorescent angiography was performed using SPY imaging system pre-and-aft operation and all angiography videos were compared and analyzed.Results Showed in angiography video of SPY,in control group and vein supercharging group,blood supply could be observed the immediately reducing,and almost be disappeared the amount of perfusion to distal area.It shows relatively constant necrosis in the distal side of control group and vein supercharging group,and the necrosis of vein supercharging group smaller than these of control group.In artery,vein supercharging group and artery supercharging group,blood perfusion could be observed separately perfusion in the upper and low area of flap.There are complete survival showed on the artery supercharging group and artery and vein supercharging group.Conclusions These findings indicated that congestive flap necrosis attribute to insufficiency of arterial blood.Arterial inflow was demonstrated more important for improved survival of distal flap than venous outflow.