【作者】 潘逢雨；

【导师】 邹云雯；

【作者基本信息】 青岛大学 ， 骨外科学， 2002， 硕士

【摘要】 目的：通过基础与临床三个试验相结合，探讨静脉血营养对脱套皮肤成活及成活质量的影响以及皮肤在低静脉血营养条件下的成活机制，为临床吻合浅静脉治疗手掌部皮肤撕脱伤寻找科学依据。 方法：实验一：以新泽西白兔为试验模型，选择新泽西白兔16只，将其双下肢随机分为试验侧和对照侧，A组为实验组，B组为对照组；A、B两组动物双后肢均形成3：1的脱套皮肤，以踝关节为蒂，其中，试验侧吻合两条回流静脉，对照原位缝合。术后通过大体观察、皮肤组织活检及皮肤成活面积统计等3种方法观察皮瓣成活情况。实验二：通过观察乳胶灌注实体标本，了解手掌部浅静脉的走行，分布，并测量其直径，为临床治疗寻找解剖学依据。实验三：临床上吻合皮肤浅静脉治疗手掌部皮肤脱套伤，以验证该手术方式的临床使用价值。 结果：实验一：试验侧脱套皮肤在各项成活指标方面均强于对照侧。实验二：手掌部有可供吻合的浅静脉。实验三：通过吻合浅静脉治疗手掌部皮肤撕脱伤24例，其中21例皮肤全部成活，成活率87.5％，另外3列除掌部有约1.5×1.0厘米的皮肤坏死 论文：静脉血营养手掌部脱套皮肤成活的实验与临床研究 外，其余部分成活。经2－5年的随访，皮肤外形美观，耐磨擦能 力强，基本恢复了原来的功能。 结论：通过吻合残静脉治疗手掌部皮肤撕脱伤，通过静脉血 回流，维持皮肤低营养，能使皮瓣成活面积和成活质量均明显提 高。该试验结果对临床手掌部皮肤脱套伤的治疗开辟了一条较为 理想的途径。更多还原

【Abstract】 Object The influence of venous-blood to to nurture the avulsion skin and the skin survival mechanism are studied hi these experiments using New Zealand white rabbits and the specimen hands as model. To evaluate the treatment of avulsion injury of palmar skin .Method : Experiment 1 :There are 16 New Zealand white rabbits in experiment 1 .The prosterior limbs of the rabbits are divided into experimental and control groups at random, group A is experimental;group B is control 3:1 distal-based-avulsion skin is made in the animals of group A and B respectively. Two veins are anastomosised in experimental side. As control another side is just sutured back to the original site. The survival condition is evaluated based on observation pathological examination and survival area calculating. Experiment 2: In order to provide scientific basis for clinical practice, we observe the hands of the specimen to know the run of palmaris superficial vein in the hands. Experiment 3: 24 cases of avulsion injury of palmar skin were primarily by anastomosing the arcus venous palmarris superficialis. 21 cases as control is just sutured back to the original site.Result rExperiment l:The survival condition of experimental group skin is better than that of control group skin based on these detection methods. t=7.140>to.o1(11), p<0.01.Experiment 2: there are many superficial venous need to be anastomot in the palmar skin. Experiment 3:The avulsion skins of 24 patients are alive. The excellent and good rate of hand function is 87.5%.Conclusion: Venous-blood-flow is very important to avulsion palmar-skin survival,which can augment the quality and area of skin .This therapy open up a path of treatment to the avulsion injury of palmar skin in clinical practice.更多还原