目的 推介将大鼠腹壁浅动脉皮瓣游离移植至腋窝的具体操作步骤。 方法 选取体重420 ~ 450 g的清洁级SD雄性大鼠20只，麻醉成功后备皮，设计以腹壁浅血管为蒂的4 cm × 2 cm腹股沟皮瓣，游离移植至腋窝，以胸外侧血管为受区血管，重点观察：股血管及胸外侧血管的起源、走行与分支，测量其外径和长度；大鼠生存状态；术后第7 d皮瓣存活情况。 结果 股动、静脉的管径分别为（0.72± 0.08）mm及（1.29±0.17）mm，胸外侧动、静脉的管径分别为（0.59±0.18）mm及（1.04±0.12）mm，两者适合做端端吻合。术后有2只大鼠死亡，另有3只大鼠皮瓣完全坏死，皮瓣存活率达75%。由于股动脉的破坏，患肢术后会出现跛行，1周后，随着血供的代偿，大鼠的步态逐渐恢复正常。 结论 大鼠腹壁浅动脉游离皮瓣是超级显微外科的基础研究与临床前操作练习的有效模型之一。
Abstract
Objective To describe the procedure of transfer of the groin flap based on the superficial epigastric artery into the axillary fossa in rats. Materials Twenty clean SD male rats weighing 420~450 g were depilated after successful anesthesia. A free groin flap model with a size of 4cm×2cm was established based on the superficial blood vessel of the abdominal wall was transplanted to the axillary fossa with the lateral thoracic vessels used as the recipient vessels. The main observations were as follows: ① the origin, course and branches of femoral vessels and lateral thoracic vessels were observed, and their outer diameter and length were measured; ② survival state of experimental animals; ③ The survival of the flap on the 7th day after operation. Results The diameter of the femoral artery and vein was (0.72±0.08) mm and (1.29±0.17) mm respectively, and that of the lateral thoracic artery and vein was (0.59±0.18) mm and (1.04±0.12) mm respectively. Two rats failed to recover from anesthesia after operation, and 3 rats had complete necrosis of skin flap, resulting in a flap survival rate of 75%. Due to removal of the femoral artery, claudication of the affected limb could occur after surgery. One week later, with compensation of the blood supply, the gait of rats gradually returned to normal. Conclusions The free flap based on the superficial epigastric artery in rats is very suitable for junior doctors and researchers who want to engage in the clinical work and the basic research relating to supramicrosurgery.
关键词
游离皮瓣 /
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腹壁浅动脉 /
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胸外侧动脉 /
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血管吻合
Key words
Free flap /
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Superficial epigastric artery /
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Common thoracic artery /
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Vascular anastomosis
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参考文献
[1] Kozusko SD, Liu X, Riccio CA, et al. Selecting a free flap for soft tissue coverage in lower extremity reconstruction[J].Injury, 2019, 50(5):S32-S39. DOI: 10.1016/j.injury.2019.10.045.
[2] Graboyes EM, Hornig JD. Evolution of the anterolateral thigh free flap[J].Curr Opin Otolaryngol Head Neck Surg, 2017, 25(5):416-421. DOI: 10.1097/MOO.0000000000000394.
[3] 徐永清，何晓清，陈雪松，等. 手和足部创面修复时四种吻合血管的皮神经营养血管穿支皮瓣的选择[J]. 中华显微外科杂志，2020，43(4):331-337. DOI:10.3760/ cma.j.cn441206-20200218-00068.
[4] 谭延曦, 潘志军，黄路，等. 内增压在修薄股前外侧穿支皮瓣游离移植修复四肢软组织缺损中的应用[J].中华显微外科杂志，2020，43(4):342-346. DOI:10.3760/cma.j.cn441206-20191129-00365.
[5] Plenter RJ, Grazia TJ. Murine heterotopic heart transplant technique[J].J Vis Exp, 2014, (89): 51511. DOI: 10.3791/51511.
[6] Pichierri A, Frati A, Santoro A, et al. How to set up a microsurgical laboratory on small animal models:organization, techniques, and impact on residency training[J]. Neurosurg Rev, 2009, 32 (1):101-110. DOI: 10.1007/s10143-008-0154-4.
[7] Edmunds MC, Wigmore S, Kluth D. In situ transverse rectus abdominis myocutaneous flap: a rat model of myocutaneous ischemiareperfusion injury[J]. J Vis Exp, 2013, (76): 50473. DOI: 10.3791/50473.
[8] 伊力扎提·伊力哈木, 朱辉, 刘爱蓬, 等. 超级显微外科血管吻合训练非活体血管模型的制备[J]. 中华显微外科杂志, 2020, 43(4): 368-370. DOI: 10.3760/cma.j.cn441206-20191125-00362.
[9] Liu HL. Microvascular anastomosis of submillimeter vessels-a training model in rats[J]. J Hand Microsurg, 2013, 5(1): 14-17. DOI: 10.1007/s12593-013-0089-z.
[10] Lähteenmäki T, Waris T, Asko-Seljavaara S, et al. Recovery of sensation in free flaps[J]. Scandinavian J Plastic Reconstructive Surg, 1989, 23(3): 217-222. DOI: 10.3109/02844318909075121.
[11] Kerawala CJ, Newlands C, Martin I. Spontaneous sensory recovery in non-innervated radial forearm flaps used for head and neck reconstruction[J]. Int J Oral Maxillofac Surg, 2006, 35(8): 714-717. DOI: 10.1016/j.ijom.2006.03.014.
[2] Boyd B, Mulholland S, Gullane P，et al. Reinnervated lateral antebrachial cutaneous neurosome flaps in oral reconstruction: are we making sense[J]? Plastic Reconstr Surg, 1994, 93(7):1360-1362. DOI: 10.1097/00006534-199406000-00004.
[13] Mah SM, Durham JS, Anderson DW, et al. Functional results in oral cavity reconstruction using reinnervated versus nonreinnervated free fasciocutaneous grafts[J]. J Otolaryngol, 1996, 25(2): 75-78. PMID: 8683656.
基金
浙江省医药卫生科技计划项目（2019KY447）
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