神经生长因子促进超长随意皮瓣成活作用的研究

Effect of nerve growth factor in promoting survival of super-length random flap.

目的研究超长随意皮瓣成活中神经生长因子的作用。方法应用Wistar大鼠背部随意皮瓣动物模型，以自身对照，于术后第1天实验组1次局部注射神经生长因子66．7μg，对照组皮下注射生理盐水0．5ml，连续观察皮瓣成活面积、皮温和成活率，以及应用激光和光导纤维技术测量不同时间的血流量、血流速度和血流容积的变化。结果断蒂后实验组皮瓣成活面积为（7．12±1．54）cm^2，成活率为（92±5）％，对照组分别为（5．23±0．19）cm。与（69±5）％，实验组明显高于对照组（P均〈0．05）。术后24h，实验组中部和尾部的血流量、血流速度、血流容积和皮温均高于对照组（P〈0．05），蒂部的血流速度亦有显著增加（P〈0．05）；3d后，实验组皮瓣蒂部的血流容积值和皮温比对照组高；至术后7d，大多数观察（皮瓣存活）指标实验组与对照组相比均增加非常显著（P〈0．01）。结论神经生长因子能通过增加皮瓣的血流量、血流速度和血流容积来提高超长随意皮瓣的成活。

Objective To study the effeet of nerqe growth factor（NGF） in survival of super-length random flap. Methods The experiment employed the animal model of random flap in Wistar＇s rat back, applied 66.7 μg NGF locally in trial group＇s flap at the first day after operation with auto-control. The survival proportion, skin tem- perature and survival rate of random flap were observed, and the blood flow, the blood flow velocity, the blood flow volume change of random flap were measured by the laser and photie-conduct fiber means in differ time. Results The survival proportion （7.12 ± 1.54）cm^2 and survival rate （92 ± 5 ）% of random flap of trial group was obviously higher （P〈0.05） than those in control group[ （5.23 ±0.19）cm^2, （69 ±5）% ] after pedicle division. The blood flow,the blood flow velocity,the blood flow volume and skin temperature in the middle and at the end of random flap in the trial group were obviously higher than those in control group 1 day after operation （ P 〈 0.05 ）, and the blood flow velocity in the pedicle of random flap in the trial group was increased markedly （ P 〈 0.05 ）. The blood flow volume and skin temperature in the pedicle of random flap in the trial group were higher than those in control group 3 days after operation （ P 〈 0.05 ）. The survival of random flap in the trial group were very significantly increased than those in control group 7 days after operation （P 〈 0.01 ）. Conclusion NGF can increase flap＇s blood flow, blood flow velocity and blood flow volume, enhancing survival of the big-proportioned and super-length random flap.