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提高静脉动脉化皮瓣成活率的实验研究

刘春利 袁伟伟 鲁开化
Experimental study of increasing the survival rate of the arterialized venous flaps
Liu Chunli,Yun Weiwei,Lu Kaihua


【摘要】 目的 提高静脉动脉化皮瓣的存活率。方法 根据静脉内皮细胞需要一定时
间以适应动脉血流,以及皮肤扩张器可增加血管密度等特点,首先将皮瓣静脉原位动脉化,
同时加用皮肤扩张器预制,10周左右行Ⅱ期皮瓣移转。结果 静脉动脉化皮瓣的存活率显著
提高,从39.13 %提高到86.36 %,挛缩率从32.08 %下降到8.9 %,两者均有统计学意义。
结论 静脉动脉化后高压、高氧动脉血流可损伤静脉内皮细胞,如先将静脉原位动脉化,待
损伤的静脉内皮细胞修复并适应动脉血流后再行皮瓣移转,可明显提高皮瓣成活率及成活质
量。
【关键词】 动脉化静脉皮瓣 皮肤扩张器 成活率

Experimental study of increasing the survival rate of the arterialized venous flaps
Liu Chunli,Yun Weiwei,Lu Kaihua.Department of Plastic Surgery ,General Hospital of Guang
Zhou Military Region,Guang Zhou 510010
【Abstract】 Objective To design a new operative method to increase the survival rate of
arterialized venous flaps.Method According to the fact that the venous endothelial cells require
time to suit the arterial blood flow and the skin expander could increase capillaries in number,
the venous flap was arterialized in situ, at the same time, a skin expander was implanted beneath
the pretransplanted arterialized venous flap. Ten or more weeks later, the flap was transplanted.
Result The survival rate of arterialized venous flap was increased remarkably, i.e. from 39.13 %
to 86.36 %, contracture rate reduced from 32.08 % to 8.9 %, both of them are statistically
significant(P<0.01). Conclusion The hypertensive and hyperoximic arterial blood could damage the
venous endothelial cells after the vein was arterialized if the flap was transplanted after the damaged
endothelial cells recovered, the survival rate and the quality of the flap could be increased remarkably.
【Key words】 Arterialized venous flap Skin expander Survival rate

静脉动脉化皮瓣优点很多,但坏死率较高,影响临床应用。因此,如何提高静脉动脉化
皮瓣的成活率是关键问题。作者在进行了一系列有关静脉动脉化皮瓣成活机理研究的基础上,
根据皮肤扩张器能增加组织血管密度,提高组织耐受缺血、缺氧能力,以及皮瓣静脉系统对
倒灌的高压、高

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