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目的:探索一种相对简单稳定的大鼠髂骨皮瓣移植手术方式,为髂骨移植诱导免疫嵌合状态的研究建立可靠的动物模型。方法:实验分为3组:空白对照组,不做任何处理;旧术式组,将供者髂骨肌皮瓣移植入受者腹股沟区,吻合供者髂腰动静脉和受者股动静脉;实验组,剥离供者髂骨臀大肌,取供者的髂骨连带肌肉及皮瓣移植于受者的腹股沟区域,将供者的髂总动脉和髂腰静脉分别与受者的股动静脉吻合,随后缝合皮肤。术后所有大鼠给予环孢素A 28天,始剂量16 mg/kg/d,第三周始每周剂量减半,第28天处死大鼠并选取髂骨做病理学检测,观测骨髓细胞量,骨陷窝是否有骨细胞等,以此判断髂骨是否成活。结果:实验组共进行手术15例,皮瓣成活11例,成功率73%;病理检测皮下髂骨成活7例,成功率47%;旧术式组共进行手术8例,皮瓣成活4例,成功率50%,病理检测皮下髂骨成活3例,成功率37.5%,其中实验组动脉吻合时间(24.7±2.3)min,明显短于旧术式组(36.7±1.5)min(均P<0.05),而静脉吻合时间、缺血时间,供受体准备时间并无差异(均P>0.05)。结论:通过剥离供者臀大肌,改变动脉吻合对象,可以建立相对简单、稳定的髂骨皮瓣移植模型,为探索带血管骨髓移植诱导嵌合状态提供了新的动物模型。
Objective: To explore a relatively simple and stable rat ilium flap transplantation for iliac bone transplantation to induce immune chimerism to establish a reliable animal model. Methods: The experiment was divided into three groups: blank control group, without any treatment; the old surgical group, the donor iliac myocutaneous flap transplanted into the recipient groin area, anastomosis of the donor iliac artery and femoral vein and recipient femoral vein In the experimental group, the donor’s iliac gluteus maximus muscle was peeled off and donor’s iliac joint muscle and flap were transplanted in the inguinal region of the recipient. The donor’s common iliac artery and iliopsoas vein were respectively transplanted with the recipient’s femoral artery Anastomosis, then suture the skin. All rats were given cyclosporine A for 28 days after the initial dose of 16 mg / kg / d, the third weekly dose was reduced by half, the rats were sacrificed on the 28th day and the ilium was selected for pathological examination to observe bone marrow cells Volume, bone lacunar osteoblasts, etc., in order to determine whether the iliac survive. Results: In the experimental group, 15 cases were operated, 11 cases were alive, and the success rate was 73%. Seven cases were subcutaneously iliac survived, the success rate was 47%. In the old operation group, 8 cases were operated and 4 cases were flap survival , Success rate was 50%, pathological examination subcutaneous iliac survival in 3 cases, the success rate was 37.5%, including experimental group arterial anastomosis time (24.7 ± 2.3) min, significantly shorter than the old surgical group (36.7 ± 1.5) min (P < 0.05). There was no difference in venous anastomosis time, ischemia time and donor preparation time (all P> 0.05). CONCLUSION: A simple and stable model of ilium flap transplantation can be established by dissecting donor gluteus maximus and changing arterial anastomosis objects. It provides a new animal model for exploring chimerism induced by vascular bone marrow transplantation.