颈阔肌皮瓣移植于食管内的病理变化的实验研究颈阔肌皮瓣移植于食管内的病理变化的实验研究

Studies on the pathological changes of platysma myocutaneous flap for cervical esophageal repairment in dogs

目的：研究颈阔肌皮瓣修复颈段食管后肌皮瓣食管连接部的愈合过程和肌皮瓣在食管腔内的病理变化。方法：建立家犬单侧横向翻转的颈阔肌皮瓣修复颈段食管半周缺损的模型，动态观察肌皮瓣在食管腔内的大体、光镜和电镜下的病理变化，测定皮肤伤口和肌皮瓣食管连接部的抗张强度。结果：肌皮瓣食管连接部的愈合比皮肤伤口延迟１～２周，术后３月、６月肌皮瓣食管连接部的胶原沉积明显增多。肌皮瓣表面皮肤在食管腔内仍保持角化，但附件退化，仍可见毛发生长。结论：肌皮瓣食管连接部早期愈合延迟，后期胶原过度沉积。肌皮瓣表面的皮肤在食管腔中半年内无显著变化。

Objective: To investigate the healing process of the anastomosis of the esophagus and the platysma myocutaneous flap (PMCF) and the pathological changes of the PMCF in the esophagus after the PMCF was used to repair the cervical esophagus. Methods: After the model of PMCF repairing defect of the cervical esophagus was established in dogs, the pathological changes of the PMCF in the esophagus were observed with optical and electron microscopy and the wound breaking strength of the cervical incision and anastomosis were determined. Results: The healing time of the anastomosis is 1～2 weeks later than that of the cervical incision. In 3 and 6 months after the operation, collagen deposition was increased at the anastomosis. The PMCF kept on keratinizing and hair growing. Conclusion: The healing time of the anastomosis is delayed in the early stage and the collagen deposition is abnormally increased at the anastomosis in the late stage after operation. The flap has no significant changes in 6 months after operation.