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目的:观察术前化疗药物直接注射对隐皮瓣存活的影响。方法:将健康成年杂种雄性犬14只,随机分为对照组和化疗组,均从右后肢内侧隐静脉予以静脉穿刺输液,左后肢不予任何静脉穿刺以自身左右对照。化疗组予以顺铂(DDP)50 mg/m2加氟尿嘧啶(5-FU)150 mg/m2化疗,分别于第1、3和5天经隐静脉给予,每21 d为1个周期,共2个周期;对照组予以等量的生理盐水及糖水注射。于第42~49天进行隐皮瓣手术,术后每天观察皮瓣变化,术后第7天用坐标贴纸法测量皮瓣存活面积后,将整个带蒂皮瓣取下,对皮瓣及隐静脉、隐动脉进行病理形态分析。结果:对照组6只,化疗组5只,共计11只试验犬存活。术后2~3 d内,各组皮瓣均有不同程度的肿胀。术后7 d,对照组非直接注射侧(A组)、对照组直接注射侧(B组)、化疗组非直接注射侧(C组)、化疗组直接注射组(D组)的皮瓣存活率相近,分别为(89.26±9.97)%、(90.25±7.55)%、(88.11±9.38)%和(88.64±11.25)%(F=0.051,P=0.984)。镜下各组均显示表皮及皮下组织生长良好。A组及C组可见少量炎性细胞浸润,未发现明显血栓形成,而B组及D组有较多的血栓形成和炎性细胞浸润。各组隐动脉内均未发现血栓形成。结论:术前化疗对直接注射静脉存在影响,其影响可能与穿刺部位的机械刺激和损伤有关,化疗药物对直接注射静脉的伴行动脉无明显影响。术前诱导化疗对隐皮瓣存活影响不明显,静脉直接注射部位仍可以作为皮瓣供区。
Objective: To observe the effect of direct injection of preoperative chemotherapeutic drugs on the survival of hidden flap. Methods: Fourteen healthy male adult male dogs were randomly divided into control group and chemotherapy group. All patients were given intravenous transfusion from the saphenous vein of the right hindlimb, while no left ventricular puncture was given to the left hind limb. Patients in the chemotherapy group received cisplatin (50 mg / m2) and 5-fluorouracil (150 mg / m2) chemotherapy, which were administered via saphenous vein on the 1st, 3rd, and 5th days respectively, with a cycle of 21 days Cycle; control group was given the same amount of saline and syrup injection. On the 42nd to 49th days, the flaps were operated and the changes of the flaps were observed daily. After the flap was measured on the 7th day by the coordinate sticker method, the entire pedicle flap was removed and the flaps and hidden Veins, the saphenous artery for pathological analysis. Results: 6 in the control group and 5 in the chemotherapy group, a total of 11 experimental dogs survived. Within 2 to 3 days after operation, the flaps in each group had different degrees of swelling. At 7 days after operation, the flaps of the control group were injected directly (group A), control group injected directly (group B), chemotherapy group injected non-injected side (group C), and chemotherapy group received direct injection (group D) (89.26 ± 9.97)%, (90.25 ± 7.55)%, (88.11 ± 9.38)% and (88.64 ± 11.25)% (F = 0.051, P = 0.984), respectively. Each group under the microscope showed that the epidermis and subcutaneous tissue grew well. A group and C group showed a small amount of inflammatory cell infiltration, no significant thrombosis, and B group and D group have more thrombosis and inflammatory cell infiltration. No thrombosis was found in all groups. Conclusion: The preoperative chemotherapy has direct influence on the intravenous injection. The effect may be related to the mechanical stimulation and injury of the puncture site. The chemotherapy drugs have no obvious effect on the direct injection of the venous artery. The effect of preoperative chemotherapy on the survival of the hidden flap was not obvious. The site of direct injection of the vein could still serve as a flap donor area.