【摘要】 目的　探讨浅静脉干用不同处理方法后对远端带蒂皮瓣的影响。方法　将 2 0只新西兰大白兔建立成远端带小隐静脉腓肠神经筋膜蒂的岛状皮瓣动物模型。按手术先后随机分为 4组 ,每组 10个皮瓣。第 1组在蒂部保留小隐静脉干 (流入 ) ;第 2组在蒂部远端 1cm将小隐静脉干结扎 (阻断 ) ;第 3组在近端重新吻合小隐静脉干 (流出 ) ;第 4组仅在皮瓣表面切开 (渗出 )。结果　第 1、4组的小隐静脉压力较第 2组显著增高 ,且超过毛细血管动脉压。皮瓣存活率第 3组 (94.5 % )与第 1组 (2 2 .7% ) ,第 2组(5 5 .5 % )和第 4组 (2 4.0 % )相比 ,差异有非常显著意义 (t =8.77、10 .2 7、P <0 .0 0 1)。第 2组较第 1、4组皮瓣的存活率明显要高 (t =3 .70、2 .82 ,P <0 .0 1)。结论　在近端重建浅静脉流出通道或在远端阻断浅静脉血流灌入 ,均能显著提高远端蒂皮瓣的存活率更多还原

【Abstract】 Objective To investigate the effects of different management of superficial vein trunk on distal pedicle flaps. Methods The model of island fasciocutaneous flap with a distal pedicle of lesser saphenous vein and sural nerve was set up in New Zealand white rabbits in this study. Twenty rabbits were randomly divided into 4 groups, with 10 in each. In group I the lesser saphenous vein trunk was left intact (inflow). In group Ⅱ it was ligated at 1 cm distal to the pedicle (interruption). In group Ⅲ re anastomosis of the vein at the proximal end was done(outflow). In group Ⅳ cutaneous incisions was made on the flap (exudation). Results The lesser saphenous venous pressure in groups Ⅰ and Ⅳ were significantly higher than that in group Ⅱ, which was higher than that of capillary artery pressure. The flap survival rate of group Ⅲ (94.5%) was significantly greater than that of groups Ⅰ (22.7%), Ⅱ (55.5%) and Ⅳ (24.0%). The flap survival rate of group Ⅱ was dramatically greater than that of groups Ⅰ and Ⅳ. Conclusion Establishing a superficial venous outflow channel by re anastomosis at the proximal end, or interrupting the inflow channel by ligation at the distal part may improve the survival rate of distal pedicle flap notably.更多还原