本文選題：深低溫保存 + 同種異體��； 參考：《南華大學(xué)》2015年碩士論文

【摘要】：目的:本實驗利用經(jīng)深低溫保存的同種異體血管移植,建立游離皮瓣血供。通過觀測移植后皮瓣存活率,推斷同種異體血管移植后血管通暢率,并與新鮮自體、新鮮同種異體血管移植進行比較。探討同種異體血管移植可行性,為臨床上應(yīng)用同種異體血管移植建立皮瓣血運提供實驗研究基礎(chǔ)。方法:將60只體重約2.5kg,雌雄不限的成年新西蘭兔按照隨機分配原則,平均分成3組,每組20只。以動物兔腹壁淺動脈為血管蒂設(shè)計一面積約5×4cm2橢圓形腹部皮瓣,并在股動脈近心端與腹壁淺動脈發(fā)出處之間截取約15mm長的股動脈,造成股動脈缺損模型。在顯微鏡下,A組用新鮮被截取的長15mm自體股動脈原位回植;B組用新鮮的長15mm同種異體股動脈移植;C組用經(jīng)深低溫保存后的長15mm同種異體股動脈移植。術(shù)后予青霉素抗炎、肝素鈉抗凝、罌粟堿抗血管痙攣。術(shù)后對各組動物兔腹部皮瓣顏色、溫度、毛細血管反應(yīng)等指標進行觀察,判斷皮瓣是否存活,推斷出各組移植后股動脈是否通暢。統(tǒng)計術(shù)后1d、2d、3d、5d、7d、14d、21d各時間點各組血管通暢率,將各組動物血管通暢率進行兩兩比較,檢驗標準以P0.05有統(tǒng)計學(xué)意義。結(jié)果:各組血管移植后要求即刻通暢率為100%(因操作不當(dāng)至失血死亡或吻合失敗等,不計入最后結(jié)果)。移植完成后,對每組實驗動物皮瓣進行各項指標觀測,各組動物未見明顯感染跡象,皮瓣存活率隨時間推移逐漸下降。A組在第1d、2d、3d、5d各有2例、2例、1例、1例皮瓣出現(xiàn)壞死;B組在第1d、2d、3d、5d、7d各有8例、4例、2例、2例、1例皮瓣出現(xiàn)壞死;C組在第1d、2d、3d、7d各有3例、2例、2例、1例皮瓣出現(xiàn)壞死。血管移植術(shù)后3周,根據(jù)皮瓣存活率推斷出血管通暢率分別為:A組為70.0%,B組為15.0%,C組為60.0%。A、B、C三組進行兩兩比較,A、C組比較,P0.05,無統(tǒng)計學(xué)差異,B組與A、C兩組比較,P0.05,有統(tǒng)計學(xué)差異。結(jié)論:經(jīng)深低溫保存后的同種異體血管移植建立血運的游離皮瓣有較好的存活率,要遠高于用新鮮同種異體血管移植組,與新鮮自體血管移植組比較無統(tǒng)計學(xué)差異。經(jīng)深低溫保存的同種異體血管移植建立游離皮瓣血供在臨床上具有一定的可行性。
[Abstract]:Objective: to establish the blood supply of free flap by deep cryopreserved allograft. By observing the survival rate of skin flap after transplantation, the patency rate of blood vessel after allograft was inferred and compared with that of fresh autograft and fresh allograft. To explore the feasibility of allograft vascular transplantation, and to provide experimental research basis for clinical application of allograft vascular transplantation to establish flap blood circulation. Methods: 60 adult New Zealand rabbits weighing about 2.5 kg were randomly divided into 3 groups with 20 rabbits in each group. A 5 脳 4cm2 elliptical abdominal flap was designed with the superficial abdominal artery of the rabbit as the vascular pedicle. The femoral artery was cut off between the proximal heart end of the femoral artery and the superficial artery of the abdominal wall, and the femoral artery was cut off from the proximal end of the femoral artery and the superficial artery of the abdominal wall. The model of femoral artery defect was established. In group A, fresh long 15mm autogenous femoral artery was replanted in situ under microscope. Group B was transplanted with fresh long 15mm allogeneic femoral artery. Group C was transplanted with long 15mm allograft after cryopreservation. Postoperative penicillin anti-inflammatory, heparin sodium anti-coagulation, papaverine anti-vasospasm. After operation, the color, temperature and capillary reaction of the abdominal flap were observed, the survival of the flap was judged, and the patency of femoral artery after transplantation was inferred. The blood vessel patency rate of each group was counted at 1 day, 2 days, 3 days, 5 days, 7 days, 14 days and 21 days. The vascular patency rate of each group was compared in two groups. The test standard was P0.05. Results: the rate of immediate patency required after vascular transplantation in each group was 100% (due to improper operation, death of blood loss or failure of anastomosis, etc.) After the transplantation, the indexes of each group of experimental animal flaps were observed, and there were no obvious signs of infection in each group. The survival rate of flap decreased gradually with the passage of time. In group A, there were 2 cases of flap necrosis in 2 cases and 1 case of skin flap necrosis on day 1, 2 d and 3 d / 5 d respectively. In group B, there were 8 cases of flap necrosis on day 1, 2 cases and 2 cases, and 1 case of flap necrosis. In group C, there were 3 cases of flap necrosis on day 1, 2 cases on day 2 and 2 cases on day 2 on day 7. In group B, there were 2 cases of flap necrosis on day 1, 2 cases on day 2 and 2 cases on day 2 at day 1. Necrosis of flap occurred in 1 case. At 3 weeks after vascular transplantation, the vascular patency rate of group B was 70. 0 and that of group B was 15. 0. The rate of patency of flap was 60. 0. 0. 05 in group C and 60. 0. 05 in group C, respectively. There was no statistical difference between group B and group A (P 0. 05). Conclusion: the free flap of blood vessel transplantation after cryopreservation has a better survival rate than that of fresh blood vessel transplantation group, and there is no statistical difference between the two groups. It is feasible to establish free flap blood supply by cryopreservation of allograft.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R654.3

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本文編號：1942095