神经生长因子对超长随意皮瓣成活状态及血流量的影响

Effects of nerve growth factor on survival status and blood flow of the ultra long random flap

目的:研究局部应用外源性神经生长因子(NGF)对促进超长随意皮瓣成活的作用机制。方法:采用大鼠背部随意皮瓣动物模型,以自身对照,于术后实验组一次局部注射NGF66.7μg,连续观察皮瓣成活面积与成活率,以及应用激光和光导纤维技术测量不同时间的血流量变化。结果:断蒂后实验组皮瓣成活面积为(7.12±1.54)cm2,成活率为(92±5)%,对照组分别为(5.23±0.19)cm2,(69±5)%,实验组明显高于对照组(t=2.33,P<0.05);术后24h实验组皮瓣中部和尾部血流量开始分别为(0.138±0.065),(0.082±0.026)mL/min·g,高于对照组(0.086±0.031),(0.051±0.037)mL/min·g,(t=2.05和2.41,P<0.05),皮瓣蒂部的血流量在5d后为(0.184±0.050)mL/min·g,对照组为(0.141±0.044)mL/min·g,比对照组增加(t=2.29,P<0.05),7d后实验组与对照组3部分血流量均出现非常显著差异,实验组尾部、中部、蒂部血流量分别为(0.151±0.051),(0.174±0.048),(0.168±0.057)mL/min·g,对照组分别为(0.088±0.062),(0.108±0.055),(0.117±0.076)mL/min·g(t=5.17,4.79,2.76,P<0.01)。结论:NGF能通过增加皮瓣的血流量来提高超长随意皮瓣的成活。

AIM:To study the effect of locally using exogenous nerve growth factor(NGF)on promoting ultra long random flap survival. METHODS:The animal model of random flap in rat back was adopted.NGF 66.7μg were locally injected once only in trial group after operation with auto control.The survival area and rate of random flap were observed continuously,and also the blood flow changes were measured by the laser and fiber optic in different time. RESULTS:The survival area and rate of random flap in trial group[(7.12±1.54) cm2,(92±5)%]were obviously higher than those in control group[(5.23±0.19) cm2,(69±5)%](t=2.33,P< 0.05) after pedicle division.The blood flows in the middle and at the end of flap in the trial group[(0.138±0.065),(0.082±0.026)mL/min·g respectively]were significantly higher than those in control group[(0.086±0.031),(0.051±0.037)mL/min·g respectively](t=2.05,2.41,P< 0.05) 24 h after operation.The blood flow of the pedicle(0.184±0.050)mL/min·g in trial group was higher than that in the control group(0.141±0.044)mL/min·g,(t=2.29,P< 0.05)at 5 day.The blood flow of three parts of end, middle and pedicle in both groups changed significantly[(0.151±0.051),(0.174±0.048),(0.168±0.057)mL/min·g in trial group,and(0.088±0.062),(0.108±0.055),(0.117±0.076)mL/min·g in control group](t=5.17,4.79,2.76,P< 0.01) at 7 day. CONCLUSION:NGF can promote survival status by increasing blood flow of the ultra long random flap.