横向骨搬移技术对缺血肢体术区微循环重建的实验研究

An experimental study of transverse bone transfer on ischemic limb microcirculation reconstruction

目的通过动物实验,探讨横向骨搬移技术对缺血肢体术区的微循环影响。方法选取6只12月龄性格较温顺的比格犬,均为雌性,平均体质量(15.7±0.6)(15.0~16.0)kg,身长(55±2)cm,胫骨长度平均为(11.0±0.8)cm,体格健康、适中,建立模拟后肢微循环闭塞的模型(实验犬的右后肢为搬移组,行横向骨搬移术;实验犬的左后肢为对照组)。观察实验犬进行横向骨搬移术后21天双后肢的术区皮温、双下肢血管造影(digital subtraction angiography,DSA)中的微动脉数量及病理活检中的微动脉数量较胫前动脉结扎术后1天的变化。结果实验犬进行横向骨搬移术后21天,搬移组(右后肢)的术区皮温(33.3±0.1)较胫前动脉结扎术后1天的术区皮温(33.2±0.3)升高,差异有统计学意义(P=0.0002);对照组(左后肢)的术区皮温(32.3±0.2)较胫前动脉结扎术后1天的术区皮温(32.1±0.3)无明显变化,差异无统计学意义(P=0.185);搬移组(右后肢)的术区皮温(33.3±0.1)较对照组(左后肢)的术区皮温(32.3±0.2)高,差异有统计学意义(P=0.0015)。搬移组(右后肢)的术区DSA中的微动脉数量较胫前动脉结扎术后1天的术区DSA中的微动脉数量增多,对照组(左后肢)的术区DSA中的微动脉数量并未出现明显变化;搬移组(右后肢)的病理活检中的微动脉数量较胫前动脉结扎术后1天的病理活检中的微动脉数量增多,对照组(左后肢)的病理活检中的微动脉数量并未出现明显变化。结论横向骨搬移术可明显促进术区微循环再生,为进一步深入研究横向骨搬移技术的分子生物学机制奠定基础。

Objective To study the effect of transverse bone transfer on microcirculation of the ischemic limb.Methods Six female 12-month-old beagle dogs were selected.The average body weight,body length,and tibial length were(15.7±0.6)(range:15.0-16.0 kg),(55±2)cm,and(11.0±0.8)cm,respectively.A model was established to simulate the occlusion of the microcirculation of the hind limbs.The right hind limbs of the experimental dogs were presented as the transfer group,and transverse bone transfer was performed.The left hind limbs of the experimental dogs were presented as control group.Changes of skin temperature,the numbers of arterioles in digital subtraction angiography(DSA)and pathologic biopsy from 1 day after anterior tibial artery ligation to 21 days after transverse bone transfer were observed.Results The skin temperature of the transfer group(33.3±0.1)was significantly higher than that 1 day after anterior tibial artery ligation(33.2±0.3)(P=0.0002).The skin temperature of the control group(32.3±0.2)was not significantly higher than that 1 day after anterior tibial artery ligation(32.1±0.3)(P=0.185).The skin temperature of the transfer group(33.3±0.1)was significantly higher than that of the control group(32.3±0.2)(P=0.0015).The numbers of arterioles of DSA and pathological biopsy in the transfer group 21 days after transverse bone transplantation increased compared with that 1 day after anterior tibial artery ligation,however,no obvious changes were seen in the control group.Conclusions Transverse bone transfer can obviously promote microcirculation regeneration,providing references for further research on the molecular biological mechanism.