相邻接轴型皮瓣间血管交通支于皮肤扩张术后变化的定量研究

Changes of vessel anastomosis in adjunction axial pattern skin flap after skin expansion： a quantitative study

目的以血管造影的方法，观察相邻接轴型皮瓣间血管交通吻合支于皮肤扩张术后变化的定量分析研究，为皮瓣的血供提供更加确凿的依据。方法于巴马猪双侧侧腹壁形成以旋髂深血管为蒂的轴型皮瓣，并分别与双侧的腹壁上动静脉轴型皮瓣相连，一侧于血管交接部位埋置皮肤扩张器为实验组，另一侧为非扩张对照组。扩张完成后，于颈动脉灌注明胶一氧化铅混悬液，获得皮肤血管的x线影像。在该图像上两血管大致的交通部位设计等距的3条平行线垂直于两血管的长轴方向，总的宽度以能覆盖所有的交通支为准，计数平行线与该区域内的血管支的切割数，并进行统计学分析。结果实验组平行线与交接区动脉切割数为81．20±10．33，对照组为22．40±5．41，两组之间比较差异有统计学意义（P〈0．01）。结论血管交通支的计量方法能真实反映血管交通支的改变，并可运用于其他实验和临床的相关研究。

Objective To conduct an empirical study for quantifying the anastomosis between two vessels after skin expanded technique by the method of angiography and to provide a precise basis for vascular study in skin flap. Methods Bilateral skin flaps based on deep iliac circumflex vessels were elevated from the abdominal wall including deep superior epigastric vessels. One was expanded at the boundary between two vessels and the other unexpanded. An X-ray image was obtained by carotid arterial injection of gelatin-lead oxide mixture. Three parallel lines with equal intervals perpendicular to long axis of the two vessels were designed at the communication area. Vessel anastomosis quantity was determined by counting the number of marks derived from the intersections of the lines and the vessels and statistical analysis was carried out. Results The marks of intersection in expanded group were more than unexpanded group with statistical significance. Conclusions The method for quantifying vessel anastomosis in skin flap is reliable. The principles of this procedure may also be applied to other experimental and clinical studies.