论文部分内容阅读
目的:以新西兰大白兔隐动静脉逆行岛状皮瓣为模型,探讨逆行岛状皮瓣中“迷宫”静脉回流途径的作用。方法:在兔后肢内侧设计切取隐动静脉逆行岛状皮瓣(面积3cm×3cm,蒂长4cm,蒂部含1cm宽筋膜),每组10个皮瓣,进行同体对照。对照组:血管蒂部不做处理,即保留“瓣膜失效”和“迷宫”两种回流途径;实验组:于血管蒂正中位置结扎两伴行静脉干,即阻断“瓣膜失效”途径。放松止血带后,连续测定1h内大隐静脉压力。术后1周测定皮瓣成活率。动物处死后蒂部组织学观察。结果:(1)测定10、20、30、40、50、60min的大隐静脉压平均值,对照组为:29.24、29.01、27.24、25.67、24.98、24.84mmHg;实验组为:37.16、36.70、37.07、36.82、35.33、37.56mmHg。在各个时间点,实验组均明显高于对照组(P<0.01)。(2)术后1周两组皮瓣平均成活率比较,对照组为(97.09±3.12)%>实验组为(87.51±13.74)%(t=2.26,P<0.05)。(3)两组皮瓣蒂部均有散在分布的扩张小静脉,实验组要多于对照组。结论:(1)“迷宫”途径较“瓣膜失效”途径更难于实现静脉逆流。(2)逆行岛状皮瓣的静脉回流以“瓣膜失效”途径为主要方式,“迷宫”途径起辅助作用。
OBJECTIVE: To investigate the role of “maze ” venous return pathways in retrograded island flaps using a retrograde island flap of the New Zealand white rabbits as a model. Methods: Inverted island flaps (3 cm × 3 cm in length, 4 cm in pedicle length and 1 cm wide fascia) were designed in the medial aspect of the hind limbs of rabbits. Ten flaps were used for allogeneic control. In the control group, the pedicle of the vessel was not treated, that is, the two reflux routes of “valve failure” and “labyrinth” were reserved. In the experimental group, Failure “approach. Relaxation tourniquet, continuous determination of the great saphenous vein within 1h pressure. One week after operation, the flap survival rate was determined. Histological observation of peduncles after sacrifice. Results: (1) The mean saphenous pressure at 10, 20, 30, 40, 50 and 60min was measured in the control group as 29.24,29.01,27.24,25.67,24.98,24.84mmHg; the experimental group was 37.16,36.70, 37.07, 36.82, 35.33, 37.56 mmHg. At all time points, the experimental group were significantly higher than the control group (P <0.01). (2) The average survival rate of the two groups at 1 week after operation was (97.09 ± 3.12)% in the control group and (87.51 ± 13.74)% in the experimental group (t = 2.26, P <0.05). (3) There were scattered small dilated veins in the flaps of the two groups of flaps, which were more in the experimental group than in the control group. CONCLUSIONS: (1) The ”labyrinthine“ approach is more difficult to achieve venous counter-current than the ”valvular failure“ approach. (2) retrograde island flap venous return to the ”valve failure“ approach as the main way, ”labyrinth " pathway play a supporting role.