摘要
目的用荧光示踪法研究逆行岛状皮瓣的静脉回流,探讨静脉回流的规律。方法40只新西兰大白兔,每只取耳静脉血各0.1 ml,分离红细胞、FITC标记及检测。40只新西兰大白兔后肢建立隐动静脉逆行岛状筋膜皮瓣模型,每只将一侧后肢随机设定为实验组,对侧即为对照组,对照组制备相同皮瓣,但不注射示踪剂。实验组按照皮瓣制备的时间不同分成A、B、C、D 4组,再根据注入示踪剂途径的不同,分为动脉和静脉2个亚组。取标记好的红细胞悬液5μl,在各组分别通过静脉和动脉注入。5 s后取下皮瓣立即冷冻,分别自血管蒂的远段、中段和近段,采用连续的3张冰冻切片(5～7μm),其中2张行HE染色和GENMED神经染色,另1张不染色直接压片。显微镜观察荧光分布。结果FITC标记的红细胞荧光强度均匀,可以用于示踪研究。冰冻切片显示试验组皮瓣蒂部均出现荧光,对照组未见荧光。A、B组荧光分布在动脉内膜、外膜和静脉壁;C组除动脉内膜、外膜和静脉壁有分布外,静脉腔偶有点片荧光;D组动脉内膜、外膜、静脉壁和静脉腔都有荧光分布。结论逆行岛状皮瓣早期静脉血通过动脉内膜、外膜和静脉壁的迷宫途径回流;后期通过动脉内膜、外膜和静脉壁的迷宫途径及经静脉腔的逆瓣膜途径回流。
Objective To investigate the venous drainage in retrograde island flap through fluorescence tracing technique and to observe the pathway of venous drainage. Methods 0. 1 ml venous blood was collected from every rabbit ear vein of 40 rabbits respectively. Erythrocytes were separated, labeled with FITC and detected. The saphenous ret- rograde island fasciocutaneous flap （4.0 cm ×3.0 cm in size with vascular pedicle length of 3.0 cm） were successfully established in hind limb of 40 New Zealand White rabbits. One side of each animal was randomly assigned to the experimental group and the contralateral side was assigned as the control. The same flap was established in the control group without giving fluorescence tracer. The experimental group was allocated into 4 groups ： A, B, C, D according to different time. Rabbits in each group were again allocated into 2 subsections with 5 rabbits each according to the different pathway to give tracer. Flap survival rate was measured in 7 days. The labeled erythrocytes （5 μl） were injected into artery or vein and then flaps were cut down 5 seconds later. The flaps were immediately frozen and chipped （5 -7 μm）. Consecutive three frozen sections were made and two of them were dyed with HE or GENMED respectively, but last one was squashed without dyeing. All frozen sections were observed under the microscope. Results FITC-labeled RBC showed steady green fluorescence observed under inversion fluorescence microscope. Fluorescence appeared in all experimental groups, but there was no in control groups. In A and B groups, there appeared mainly fluorescence in wall of vein and inner membrane and outer membrane of artery. In C and D groups, fluorescence dis- tributed principally in inner membrane and outer membrane of artery, wall of vein and lumen of the vein. Conclusions In earlier period, venous retrograde return in retrograde island flaps is through inner membrane and outer membrane of artery and wall of vein which is called ＂circuitous route＂. In later period,
出处
《临床骨科杂志》
2009年第2期222-226,共5页
Journal of Clinical Orthopaedics
基金
国家自然科学基金(编号:C03030306)
关键词
逆行岛状皮瓣
静脉回流
荧光示踪
retrograde island flaps
venous drainage
fluorescence tracing
