抗癌药物动脉灌注对局部轴型皮瓣血供的影响

Impact of arterial perfusion with anticancer drug on the blood supply in axial-pattern flap

目的探讨抗癌药物动脉灌注对局部轴型皮瓣血液供应的影响。方法在猪腹部双侧腹壁上动脉插管灌注入抗癌药，10d后在猪腹部双侧设计以腹壁上血管为蒂的岛状皮瓣，观察灌注区域轴型血管供养的岛状皮瓣成活率。以近红外光谱作皮瓣组织氧含量指数（TOI）的测定。用组织学检查和血管铸型透明标本研究其血管结构及构筑的变化。结果抗癌药物局部动脉灌注后两个实验组局部轴型皮瓣的成活率及TOI数值均有下降，与对照组间差异有统计学意义。组织学检查和血管铸型标本显示实验组支配血管有损伤表现、血管网分布范围缩小约1／5，岛状皮瓣远段的血供显著降低。结论抗癌药物动脉灌注可影响局部轴型皮瓣的血运，使皮瓣血供的安全范围缩小。

Objective To investigate the influence of arterial perfusion with anticancer drug on the blood supply in axial-pattern flaps, Methods Anticancer drug was infused to the abdominal artery on the bilateral abdom of the mini-pig, After ten days ,the axial-pattern flaps were elevated on the bilateral abdomen. The monitoring of blood oxygenation in flap was performed using near infrared spectroscopy. The vascular architecture changes were also recorded using histological examination and the transparent vascular casting. Results After anticancer drug perfusion, the survival rate and the tissue oxygenation index decreased in two experimental groups, which were significantly different to control group, Meanwhile in two experimental groups, the blood supply decreased significantly in distal segment of the flap, injury occurred in the vascular net, and the vessel distributed scope reduced in the axial-pattern flap, Conclusions Anticancer drug arterial infusion can cause injuries of the vessel network in the axial over-expanded flap, and reduce the scope for flap supplies safety.