胸廓内动静脉远心端血液动力学动物模型

A hemodynamic animal model of distal ends of internal mammary artery and vein

目的 为了明确胸廓内动脉远心端供血能力 ,以及胸廓内静脉远心端回流能力。方法 选择 2头小型猪 ,每头猪形成髂腰部皮瓣左右侧各 1个 ,共 4个 ,均为以旋髂深动静脉的直接皮动脉为蒂的岛状轴型皮瓣。测量蒂部的压力、流量 ,分别与胸廓内动脉远近心端的压力相比较 ,将皮瓣蒂部的动静脉与胸廓内动静脉远心端行端端吻合的游离移植 ,测量吻合口于吻合后即刻、30、6 0min流量 ,测量皮瓣原位及吻合血管后皮瓣相应状态下包括术后 7d、14d的灌注值 (PU)。术后观察皮瓣成活情况。结果 胸廓内动脉远心端压力为近心端压力的 6 1%～ 6 5 % ,单独胸廓内动、静脉远心端可使 15cm× 30cm× 2cm游离皮瓣全部成活。结论 虽然胸廓内动脉远心端的压力较低 ,但具有足够的供血能力 ,胸廓内静脉远心端具有足够的回流能力 ;以旋髂深动静脉的直接皮动脉为蒂的岛状皮瓣是理想的轴型皮瓣动物模型 ;建立了以旋髂深动静脉为蒂的游离皮瓣与胸廓内动静脉远心端直接吻合的动物模型 ,可进一步推广应用。

Objective To verify the ability of distal ends of internal mammary artery and vein used as recipient vessels on breast and chest wall reconstruction. Methods Four bilateral (left 2 and right 2) scent pig buttock island flaps pedicled circle deep iliac artery and vein were used by comparing the different hemodynamic parameters (pressure; flux volume; perfusion unions) between the original pedicl artery (deep iliac artery), proximal and distal ends of internal mammary artery. The free flaps were transplantated by anastomosed end-end to the distal-ends of internal mammary artery and vein after the proximal ends were ligated. Results The pressure of distal end of internal mammary artery was 61%-65% of the pressure with original pedicl artery (deep iliac artery), the immediate volume of anastomasis stoma was a little lower than that of original pedicl artery. The flap, 15 cm×30 cm×2 cm in size, completely survived more than 14 days after operation. Conclusion The slightly decreased distal arterial pressure does not compromise flap survival. Bilateral scent pig buttock island flap pedicled circle deep iliac artery and vein is an ideal animal flap model. This hymodynamic model can be widely used .