腹部皮瓣微血管密度的测定

Determination of microvessel density of abdominal flap

目的探讨腹部皮瓣不同层次和区域微血管密度（MVD）的差异。方法取60例腹部手术患者的腹部皮瓣，腹部Ⅰ-Ⅵ区各10例。采用免疫组化方法，选取CD34标记血管内皮细胞，测定并比较各区及各层腹部皮瓣MVD。结果腹部皮瓣血管网分5层，即真皮乳头层、真皮乳头下层、真皮深层、浅筋膜层和深筋膜层，各层MVD平均分别为17.80±1.68、9.12±1.84、27.91±2.44、37.18±6.55和46.91±7.02，各层比较有统计学差异（P〈0.01），以深筋膜层最密，浅筋膜层次之，真皮深层和真皮乳头层居中，以真皮乳头下层最稀。腹部各层6个区的MVD无统计学差异（P〉0.05）。结论腹部大型动脉皮瓣的成活有其解剖学依据，移植方式采取顺行或逆行均可。

Objective To determine the difference of microvessel density（MVD） in each layer and region of abdominal flap. Methods Flaps were obtained from 60 patients with abdominal operations, 10 in each of the regions from Ⅰ to Ⅵ. The vascular endothelial cells were marked with CD34 by immunohistochemistry, and the MVD in each region and layer of the abdominal flaps was determined. Results The vascular net of abdominal flap was divided into five layers ： papillary layer of corium, papillary underlayer of corium, papillary deep layer of corium, superficial fascia and deep fascia. The mean MVD of the five layers were 17.80 ±1.68, 9.12 ±1.84, 27.91 ± 2.44, 37.18 ± 6.55 and 46.91 ± 7.02, respectively, with significant differences among them （ P 〈 0.01 ）. However, there were no significant differences in the mean MVD among the six regions in each layer（P 〉 0.05）. Conclusion Anatomic factors may be responsible for the survival of large abdominal flaps. Either of the direct and retrograde motion is feasible in the transplantation.