【摘要】 目的　介绍延迟性足趾移植的方法、指征并探讨其机制。　方法　为 10例足趾移植术中发生血液循环危象的病例进行延迟手术 ,于术后 17～ 2 1小时断蒂进行移植。实验应用 3 6只大白兔后肢离断保留血管蒂模型 ,于术后 4、8、16、2 4小时对局部肢体组织及动脉壁进行内皮素 ( ET)及一氧化氮( NO)含量检测 ,全部数据作统计学处理。　结果　临床 10例延迟性足趾移植术全部成活。实验显示 ,术后 4～ 8小时局部组织及动脉壁内 ET含量明显增高而 NO含量显著下降 ;术后 16～ 2 4小时 ,ET含量下降至正常而 NO含量显著升高。　结论　延迟性足趾移植是解决术后血管变异及血循危象的有效方法 ,其作用机制与局部组织及动脉壁 ET及 NO含量的变化有关。更多还原

【Abstract】 Objective To introduce the measures of delayed toe transplantation,and discuss its mechamism and indications Methods In 10 cases of the transplantation in which circulatory crisis occurred, the operation was delayed The vascular pedicle was divided and the toe was transferred 17 to 21 hours after the donor toe was dissected In 36 rabbits, the hind limbs were severed except for the vascular pedicle The endothelin (ET) and nitric oxide (NO) content of the tissues in the hind limb and the arterial wall were tested in postoperative intervals of 4,8,16,and 24 hours respectively All the data were subject to statistic analysis Results In 10 cases of delayed toe transplantation, all toes survived The results of the experiment showed that there was significant increase of ET content and decrease of NO content in the local tissues and the arterial wall 4 to 8 hours after the operation In postoperative 16 to 24 hours, ET content returned to normal level and NO content increased remarkably Conclusions Delayed pedicle division and toe transfer is an effective method in toe transplantation with vascular variations and circulatory crisis The mechanism is related to the ET and NO content in local tissue and arterial wall更多还原