大鼠腹壁动脉穿支皮瓣模型的建立

Establishment of a deep epigastric perforator flap model in rats

目的 建立大鼠腹壁动脉穿支（DEP）模型,观察无干预情况下皮瓣成活过程.方法 观察大鼠腹壁穿支血管解剖,构建单一腹壁肌皮穿支血供模型,皮瓣上至肋弓缘,下至髂前上棘,侧至腋中线.术后观察皮瓣,检测微血管密度、胶原含量.结果 构建以右腹壁第2肌皮穿支血管为单一血供的3.0 cm×6.5 cm～3.0 cm×7.0 cm皮瓣,单一穿支血管可供养皮瓣.术后1周存活区界限出现;2周坏死区完全变黑干缩.术后早期（1～3 d）以组织水肿和炎性细胞浸润为主,晚期（7～14 d）以血管生成和胶原沉积为主.术后1～3 d皮瓣MVD上升（P〈0.05）,胶原含量下降但无统计学意义（P〉0.05）;3～5 d均渐上升（P〈0.05）,分别在第5天和第10天左右达到高峰（P〈0.01）,后维持在较高水平.结论 大鼠DEP模型是稳定可靠的穿支皮瓣乳房再造研究模型.

Objective To establish a stable rat deep epigastric perforator （DEP） model and record the flap survival progress without interference. Methods The anatomical characteristics of the musculocutaneous perforating vessels were investigated, and a single deep epigastric perforator flap was established,subsequently. The upper bound of the flap was costal margin,the lower bound was the level of the anterior superior iliac spine, and the lateral bound was midaxillary line. The flaps survival progress was recorded,and the microvessel density （MVD） and collagen deposition at different time points were examined by immunodetection of VWF and picric-sirius red stain,respectively. Results The 2nd perforator was selected as supplying vessels for the DEP flap,whose area was 3.0 cm × 6.5 cm-3.0 cm × 7.0 cm. The boundary between survival and necrotic zones appeared one week after operation. The skin-color and capillary reaction in the survival zone restored to the normal manifestations and the necrosis region became black and hard drying completely at the second week. In the early period （1-3 days） post-operation,tissue edema and infiltration of inflammatory cells were observed, while in later period （7-14 days） angiogenesis and collagen deposition were observed. The MVD was increased significantly （P 〈 0. 05）, but collagen deposition decreased un-significantly （P〉0.05） in the first 3 days post-operation,gradually elevated in the 3-5days （P〈0.05） .reached the peak at the 5th and 10th day （P〈 0.001） .respectively,and remained the high level up to the end of the experiment,subsequently. Conclusion Rat DEP model is a stable and reliable flap animal one for human deep inferior epigastric perforator （DIEP） flap breast reconstruction.