摘要
目的监测远端坏死的穿支皮瓣经皮氧分压(tcPaO2)的变化规律,为临床工作提供实验依据。方法应用体质量400～450g雄性Wistar大鼠100只,在其背部作以髂腰皮动脉为蒂的穿支皮瓣,面积约12cm×3cm,以穿支穿出点为近端到皮瓣远端均分为4个区域依次为1、2、3、4区,分别在术前及术后0、1、2、4、7d监测各区域的tcPaO2值。结果术后各区域0dtcPaO2值较术前明显降低(P<0.01)。术后1、2、4、7d近端3个区域的tcPaO2值逐渐升高(P<0.01),术后7d达到最高,其中近端2个区域基本达到正常水平;远端4区的tcPaO2值逐渐降低(P<0.01),术后4d全部坏死。术后1、2d由近端到远端tcPaO2值先升高后降低,2区明显高于1区与3、4区(P<0.05);术后4、7d由近端到远端tcPaO2值呈降低趋势(P<0.05),1、2两个区域tcPaO2值差异无统计学意义(P>0.05)。结论tcPaO2可以客观、连续、定量地反映皮瓣的血液供应状态,有助于早期发现皮瓣的血运障碍,在临床上有很大的应用前景。
Objective To explore the variation pattern of transcutaneons oxygen tension （tcPaO2） of flaps pedicled on the arterial cutaneous branch with necrotic distal end and to provide experimental evidence for chnical practice. Methods Flaps pedicled on the cutaneous branch of the iliolumbal artery were raised on 65 male Wistar rats （400-450 g） with a 12 cm×3 cm dimension. By taking a perforation point of the cutaneous branch as the proximal end, each flap was divided into four equal regions （region 1 to 4） from the proximal end to the distal end. The tcPaO2 of each region was monitored at the following time points ： before the oper- ation, immediately after the operation, at the 1 st, 2nd, 4th and 7th day after the operation. Results tcPaO2 of the four regions all significantly dropped after the operation（ P 〈 0.01）. tcPaO2 values of the proximal three regions （region 1 to 3） gradually in- creased from the 1st day to the 7th day after the operation. And on the 7th day, tcPaO2 values of region 1 and 2 nearly regained their normal levels. While tcPaO2 of the distal necrotic region （region 4） gradually dropped till it could not be tested on the 4th day. On the 1st and 2nd days after the operation, from proxinml to distal end of the flap, tcPaO2 first increased and then gradually dropped, tcPaO2 of region 2 was significantly higher than that of region 1, 3 and 4（ P 〈 0.05）. While on the 4th and 7th days, tcPaO2 gradually dropped from proximal to distal end of the flap（ P 〈 0.05）, and differences between the proximal two regions diminished（ P 〉 0.05）. Conclusion By using transcutaneons oxygen tension measurement, blood circulation condition of the flap can be objectively and continuously reflected, and dysaemia of the flap can be detected in its early state. Therefore, transcutaneons oxygen tension measurement can be a premising detection method in clinical practice.
出处
《山东大学学报（医学版）》
CAS
北大核心
2009年第4期79-82,共4页
Journal of Shandong University:Health Sciences
关键词
穿支皮瓣
经皮氧分压
Cutaneous branches skin flap
Percutaneous oxygen partial pressure
