皮瓣移植后毛细血管襻变化的研究

The Observation of the Capillary Loops in the Transplanted Flaps

目的探讨皮瓣移植后毛细血管襻(FCL)的变化。方法检测20例26个移植到手部的皮瓣,分别于移植后6、12、24h、3、5、7、14d观察皮瓣FCL的状况,并与皮瓣供区对应的健侧对比。结果皮瓣移植术后无血管危象的病例,术后瓣内FCL与健侧相应部位皮肤的FCL数量、宽度基本一致(P>0.05);术后出现静脉回流不足的病例,可于术后48h内观察到大量FCL,密度较健侧明显增多、宽大(P<0.05),阻断近端动脉后,FCL数目无明显变化,但襻的形态明显变小、变短;皮瓣发生动脉危象者,皮瓣内FCL消失,阻断近端静脉时,可见皮瓣内FCL缓慢出现,但密度、宽度较健侧明显小(P<0.01)。结论皮瓣FCL的检测是观察皮瓣术后血循环变化较好的方法。

Objective To discuss the value of the capillary loops in the assessment of vessel malfunction and crisis in the transplanted flap. Methods 26 flaps in 20 cases were tested. The FCL was observed 6, 12, 24 hours and 3, 5, 7, 14 days postoperation. Results In the cases without complication, the number and size of the FCL in flaps were a little larger than the donor skin of the ipsilateral side（P 〉 0. 05）; while in the cases with the veinous malfunction and crisis, the FCL appeared much larger in nubmer and size（P 〈 0. 05）, but it had response to the artery block in venous malfunction flaps, and no response in venous crisis. In the artery malfunction, FCL appeared less in number and smaller in size（P 〈0. 05）, but it had response to vein block, and for the artery crisis, it had no response at all. Conclusion The observation of FCL is a relatively good method in the assessment of replanted flaps.