大鼠横行腹直肌皮瓣解剖特点及建模的研究

-The established method of the transverse rectus abdominis myocutaneous flap in rats and correlative anatomy of the animal model

目的研究大鼠横行腹直肌(TRAM)皮瓣的解剖特点,确定合理的建模方案。方法选取45只成年Wistar大鼠,将其分为解剖组(A组),用于研究TRAM皮瓣的相关解剖特点;正常皮瓣组(N组)建立以腹壁下血管为蒂的TRAM皮瓣,建模无缺血刺激;缺血皮瓣组(I组),建立以腹壁下血管为蒂的TRAM皮瓣,建模后诱导皮瓣缺血4 h;每组15只。建模后,术后第7天评估皮瓣成活情况,分析大鼠TRAM皮瓣的建模成功率。结果 TRAM皮瓣两侧经腹直肌的供血皮支数量及腹壁下血管直径比较,差异无统计学意义(P>0.05)。所有TRAM皮瓣模型均建立成功,无皮瓣完全坏死。N组平均存活面积比为(68.1±7.5)%,I组平均存活面积比为(43.6±6.6)%。结论建立稳定有效的大鼠TRAM皮瓣模型是可行的,良好的解剖学基础和熟练的显微外科操作技术是模型成功的关键。

Objective To establish an available and stable transverse rectus abdominis myocutaneous （TRAM） flap model in rats by anatomic research.Methods Forty-five male Wistar rats were randomly divided into three groups of fifteen animals in each group.Fifteen animals in the anatomy group （A group） were anatomized to grasp the anatomic characteristics of the animal model.A transverse rectus abdominis musculocutaneous flap based on the inferior epigastric vessels was elevated in each animal of the normal flap group （N group） and ischemic flap group （I group）.Flaps in the N group were served as normal flap models without ischemic procedure.Flaps with 4 hours of global ischemia were served as ischemic flap models in the I group by pedicle clamping.Flap survival area was evaluated on the seventh postoperative day by computered video planimetry.Results The number of perforating branches and the diameter of the inferior epigastric artery and vein had no difference between both sides （P〉0.05）.All of the models were successful. The ratio of the flap survival area was （68.1±7.5）% in N group,and was （43.6±6.6）% in the I group.Conclusion The TRAM flap model is stable and reproducible,so it is in favor of a series of researches on flaps.Because the inferior epigastric vessels in rats are thin,it is very important to have a good grasp of the anatomy of rats and operative skills of microsurgery.