犬咽后壁瓣微血管构筑的组织学研究

The Blood Vessel Reconstruction of Posterior Pharyngeal Flap: a Histology Study

目的:研究上、下蒂型咽后壁瓣术后不同时期、不同部位血管重建情况。方法:将10只杂种犬随机分为两组,每组5只,分别作上、下蒂型咽后壁瓣手术,并分别于术后即刻及术后3、7、30、90d处死,采用血管造影、常规HE切片,光镜观察及计算机图象分析等方法,比较术后不同时期、不同部位的平均血管数量和横截面积的变化。另1只犬直接处死,血管造影,取对应部位作正常对照。结果:上蒂型咽后壁瓣术后即刻无血管显影,但其血管重建较快;术后不同部位血管重建同步,分布均匀,其平均横截面积、血管数量逐渐增加,30d后和对照组相近(P>0.05)。下蒂型咽后壁瓣术后即刻蒂部有少量血管显影;术后不同部位血管重建不同步,分布不均匀,术后血管重建首先发生在瓣蒂区和瓣尖肌肉层,其平均横截面积、血管数量逐渐增加,30d时和对照组相近(P>0.05)。术后早期瓣中部和瓣尖粘膜下无血管显影,其血管重建较慢,瓣中部一直血管稀少,90d时才和对照组相近。结论:上、下蒂型咽后壁瓣术后均能建立和术前相近、分布均匀的血管网。

Objective: To investigate the blood vessel reconstruction that occurred in the superiorly and inferiorly based posterior pharyngeal flaps in different site and postoperative time. Methods: Ten mongrel dogs were randomly divided into two experimental groups, which were performed superiorly or inferiorly based posterior pharyngeal flap surgery respectively. Each group was then subdivided into five subgroups ,and were sacrificed immediately after operation or on 3, 7, 30, 90d postoperative respectivly. One mongrel dog was used as normal control. Microangiography and histology were used to assess the vessel. Results: (1) The number and vessel-cross-section area increased rapidly in the superiorly based posterior pharyngeal flap and returned to normal in the 30d flap. The blood vessel distributed equally and reconstructed synchronistically in different site of the flap. (2) The number and vessel-cross-section area increasing was firstly occurred in the pedicle and the muscular layer of the apex, which returned to normal in the 30d inferiorly based posterior pharyngeal flap. There were no blood vessel in the middle and the submucous layer of the apex during the early postoperative period.The middle of the flap remains as a blood vessel sparse area until 90d postoperative. Conclusion: Both superiorly and inferiorly based posterior pharyngeal flap can reconstruct an equally distributed blood vascular network.