摘要
目的探讨电针刺激对大鼠跨区穿支皮瓣成活的影响及其机制。方法该研究为实验研究。取30只8~10周龄雄性SD大鼠,采用随机数字表法将其分为电针刺激组和对照组,每组15只。采用多普勒血流探测仪探查2组大鼠背部旋髂深动脉、肋间后动脉、胸背动脉位置,设计并切取结扎肋间后动脉、胸背动脉后以旋髂深动脉为蒂的跨区穿支皮瓣,并将皮瓣原位回植。术前,对电针刺激组大鼠皮瓣胸背动脉与肋间后动脉所在血管体之间交界部位包含闭塞血管的区域(即闭塞区域Ⅱ)皮肤行连续7 d、每天1 h的电针刺激,对照组大鼠皮瓣不接受电针刺激。术后7 d,观察2组所有大鼠皮瓣成活情况并计算皮瓣成活率;取闭塞区域Ⅱ皮肤组织,行苏木精-伊红染色后观察微血管新生情况并计算微血管密度(样本数为3),行免疫组织化学染色观察血管内皮生长因子(VEGF)的表达与分布,采用蛋白质印迹法检测VEGF的蛋白表达(样本数为3)。结果术后7 d,对照组大鼠皮瓣部分发黑、坏死,电针刺激组大鼠皮瓣成活、几乎无坏死;电针刺激组大鼠皮瓣成活率为(92.1±2.1)%,显著高于对照组的(85.2±1.2)%(t=-10.95,P<0.05)。术后7 d,与对照组比较,电针刺激组大鼠皮瓣闭塞区域Ⅱ皮肤组织中新生微血管明显增多;电针刺激组大鼠皮瓣闭塞区域Ⅱ皮肤组织中微血管密度为(21.4±3.0)条/mm 2,显著高于对照组的(11.5±3.7)条/mm 2(t=-7.34,P<0.05)。术后7 d,与对照组比较,电针刺激组大鼠皮瓣闭塞区域Ⅱ皮肤组织中血管区VEGF的表达明显增多,VEGF蛋白表达显著增高(t=12.56,P<0.05)。结论电针刺激可提高大鼠跨区穿支皮瓣闭塞区域Ⅱ中VEGF的表达,通过促进该区域中血管发生形态学改变而改善皮瓣远端血供,从而提高皮瓣成活率。
Objective To explore the effects and mechanism of electroacupuncture stimulation on the survival of multi-territory perforator flaps in rats.Methods This study was an experimental study.Thirty male Sprague-Dawley rats aged 8-10 weeks were collected and divided into electroacupuncture stimulation group and control group according to the random number table method,with 15 rats in each group.Doppler blood flow detectors were used to explore the positions of the dorsal deep circumflex artery,posterior intercostal artery,and thoracodorsal artery in the two groups of rats,and a multi-territory perforator flap was designed and resected with the dorsal deep circumflex artery as the pedicle after ligation of the posterior intercostal artery and thoracodorsal artery,and the flap was replanted in situ.Before the operation,the skin in the area containing choke vessels at the junction between the angiosomes of the thoracodorsal artery and posterior intercostal artery(i.e.the choke zoneⅡ)in the flaps of rats in electroacupuncture stimulation group was subjected to electroacupuncture stimulation for 1 hour per day for 7 consecutive days,while the flaps of rats in control group received no electroacupuncture stimulation.Seven days after the operation,the survival status of the flaps of all rats in the two groups was observed and the flap survival rate was calculated;the skin tissue from the choke zoneⅡwas collected and stained with hematoxylin-eosin to observe the microvascular neogenesis and calculate the microvessel density(with sample number of 3).Immunohistochemical staining was performed to observe the expression and distribution of vascular endothelial growth factor(VEGF),and Western blotting was used to detect the protein expression of VEGF(with sample number of 3).Results Seven days after the operation,the flaps of rats in control group were partially blackened and necrotic,while those in electroacupuncture stimulation group survived with almost no necrosis.The flap survival rate of rats in electroacupuncture stimulation group was(92.1±2.1)%,which was significantly higher than(85.2±1.2)%in control group(t=-10.95,P<0.05).Seven days after the operation,compared with those in control group,the number of new microvessels in the skin tissue in the choke zoneⅡof the flaps in rats of electroacupuncture stimulation group increased significantly.The microvessel density in the skin tissue in the choke zoneⅡof the flaps in rats of electroacupuncture stimulation group was(21.4±3.0)vessels/mm²,which was significantly higher than(11.5±3.7)vessels/mm²in control group(t=-7.34,P<0.05).Seven days after the operation,compared with those in control group,the expression of VEGF in the vascular area of the skin tissue in the choke zoneⅡof the flaps in rats of electroacupuncture stimulation group was significantly increased,and the protein expression of VEGF was significantly increased(t=12.56,P<0.05).Conclusions Electroacupuncture stimulation can increase the expression of VEGF in choke zoneⅡof the multi-territory perforator flaps in rats,improve the blood supply at the distal end of flaps through promoting morphological changes of blood vessels in this zone,thus increasing the survival rates of flaps.
作者
霍磊
谢佳宁
谭琪
Huo Lei;Xie Jianing;Tan Qi(Clinical Medical School,Shandong Second Medical University,Weifang 261000,China;Orthopaedic Trauma Department,Weifang People's Hospital,Weifang 261041,China)
出处
《中华烧伤与创面修复杂志》
北大核心
2025年第8期775-782,共8页
Chinese Journal of Burns And Wounds
基金
潍坊市卫生健康委员会科研项目(wfwsjk_2019_024)。
关键词
电刺激
电针
穿支皮瓣
血管体
闭塞血管
血管形态学
血管内皮生长因子
Electric stimulation
Electroacupuncture
Perforator flap
Angiosomes
Choke vessles
Morphology of blood vessels
Vascular endothelial growth factor
作者简介
通信作者:谭琪,Email:tanqiplastic@126.com。
