兔血管束预构带软骨复合组织瓣成活的机制(Ⅱ)

Surviving mechanism of vascular bundle prefabricated flap with cartilage composite tissue in rabbits

目的 探讨预构带软骨复合组织瓣成活的解剖学基础 .方法 采用雄性日本大耳白兔 37只 ,将 A组 2 0只于预构术后 7,10 ,14,2 1和 2 8d行 70 0 m L· L- 1中华墨汁低分子右旋糖酐液灌注 ,活体观察皮瓣的染色范围 .B组 10只 ,于术后 7,10 ,14,2 1和 2 8d行乳胶、硫酸钡、铅丹造影 . C组 7只 ,于术后 7,10 ,14,2 1和 2 8d行预构复合组织瓣及任意皮瓣、轴型皮瓣 ,ECT照像检查复合组织瓣血流变化情况 .结果 A组活体染色 ,2 wk始近蒂部染色 ,渐向皮瓣远端 ,4wk皮瓣基本染色完全 .B组造影显示 ,10 d后 ,有血管新生 ,3wk后有吻合枝出现 . C组 ECT照像证明 ,随时间延长 ,预构复合组织瓣血流量增加 ,4wk时血流量较轴型皮瓣少 ,高于任意皮瓣 .结论 预构带软骨的复合组织瓣成活主要依靠预构血管与原皮瓣内血管的吻合 ,新生血管不足以形成独立的供血 。

AIM To investigate the anatomic basis for the survival of the prefabricated flap with cartialge composite tissue. METHODS Thirty seven Japanese male white rabbits were divided into three groups: A, B and C. On the 7th, 14th, 21st and 28th days after the prefabrication, 20 rabbits in Group A were perfused with 700 mL·L -1 China ink low molecular dextran, and viviperception was also performed toobserve the staining area on the flap. Ten rabbits in Group B were given emulsion, barium sulfate and red lead contrasts. The rest in Group C received ECT photography on the prefabricated composite tissue flap, the random flap and the afial flap. In order to examine the changes in the blood stream of the composite tissue flap. RESULTS For Group A, vivistraining was performed. The staining area extended from the pedicle to the distal parts of the flap from the 2nd week on and the flap was not completely stained until the 4th week. For Group B, the contrasts showed that some new vessels formed 10 days after the prefabrication, and some anostomosis appeared 3 weeks after the prefabrication. For Group C, ECT photography confirmed that with the elapse of time, the volume of blood flow in the composite tissue flap increased, and in the fourth week, this volume was smaller than that of the afial flap but greater than that of the random flap. CONCLUSION The survival of prefabricated composite tissue flap depends mainly on the anostomosis between the prefabricated and the original vessels and the neoformative vessels alone cannot provide enough blood for flap survival but can perform some perfective and supplementary function.