蒂部动脉位置对跨区穿支皮瓣成活的影响

Influence of pedicled artery position on the survival of multi-territory perforator flap

目的通过改变蒂部动脉的位置,探讨其对跨区穿支皮瓣成活的影响。方法将32只SD大鼠随机分成两组:对照组,保留右侧髂腰动、静脉;实验组,保留右侧髂腰静脉+左侧髂腰动脉。术后7 d,统计皮瓣成活率,血管造影观察choke动脉扩张情况,HE染色显微镜下测量choke动脉的腔内直径。结果术后7 d,实验组皮瓣成活率高于对照组,(85.5±2.9)%vs(68.9±2.6)%,P<0.001;两组choke1动脉扩张程度相当,(46.93±6.21)μm vs(46.79±6.69)μm,P>0.05,实验组choke2动脉扩张较对照组更明显,(66.08±6.78)μm vs(46.00±6.90)μm,P<0.001。结论蒂部动脉位置改变,可促进choke动脉扩张和皮瓣远端供血,从而提高跨区穿支皮瓣成活率。

Objective To investigate the influence of the pedicled artery position on the survival of multi-territory perforator flap.Methods Thirty-two Sprague-Dawley rats were randomly divided into two groups:a control group,only the right iliolumbar artery and vein were preserved;and an experimental group,only the right iliolumbar vein and the left iliolumbar artery were preserved.At 7 days after operation,the survival of the flap was counted.Arteriography was performed to observe the dilation of the choke arteries,and HE staining microscope was used to measure the intraluminal diameter of the choke artery.Results At 7 days after operation,the survival rate of the flap in the experimental group was significantly higher than that in the control group[(85.5±2.9)%vs(68.9±2.6)%,P<0.001].The dilation of the choke1 artery was comparable in both groups[(46.93±6.21)μm vs(46.79±6.69)μm,P>0.05],whereas the choke 2 artery in the experimental group was more dilated than that in the control group[(66.08±6.78)μm vs(46.00±6.90)μm,P<0.001].Conclusions The position change of the pedicled artery can promote the dilation of the choke artery and the blood supply to the distal part of the flap,so as to increase the survival rate of multi-territory perforator flap.