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Study of technique of vascular anastomosis and monitoring of blood flow for improving rates of free tissue transplantation

血管吻合及血流监测技术提高游离组织移植率的研究

基本信息

批准号：
19390519
负责人：
SASAGURI Masaaki
金额：
$ 5.57万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2007
资助国家：
日本
起止时间：
2007 至 2010
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-19390519/
关键词：
遊離組織移植微小血管吻合皮弁血流血管吻合

项目摘要

The purpose of this study is to establish vascular anastomosis technique and postoperative management method for improving the success rate of free tissue transplantation with microvascular anastomosis.(1)Disturbance of blood flow due to differences in condition of vascular anastomosis : Thrombogenic anastomosis led to disturbance of blood flow at a high rate. Anticoagulation therapy with subcutaneous heparin administration could not suppress the thrombus formation in the cases of experimental thrombogenic anastomosis. Flexion of the blood vessel pattern did not affect the blood flow failure.(2)The blood flow disturbance and the ischemic time of the flap : With the extension of the time of flap ischemia, the incidence of failure of blood flow was increased. The blood flow obstruction was suppressed by heparin treatment to the flap during ischemia of the flap.(3) Postoperative blood flows of the flaps were observed using a laser Doppler flowmetry(LDF) in the cases of oral cavity reconstruction by free tissue transplantation. The averageblood flow rate in the flaps gradually increased after the operation, and then became stable untilday 3. In addition, after PGE1 administration, the flap blood flow increased by 30-40% and increase in blood flow was sustained for 3-4 hours. In this way, the changes in blood flow in postoperative flap, it was found to give a uniform pattern. On the other hand, resulted in failure of blood flow in patients after surgery, blood flow patterns were different. Careful monitoring of the flaps by LDF may provide significant information for quickly identifying circulation disturbances in the flaps prior to macroscopic change of the flap

本研究旨在建立吻合血管的游离组织移植技术和术后管理方法，以提高吻合血管游离组织移植的成功率。（1）由于血管吻合条件的差异导致的血流障碍：血栓形成性吻合导致血流障碍率高。皮下注射肝素抗凝治疗不能抑制实验性血栓形成吻合口的血栓形成。血管形态的改变不影响血流衰竭。（2）皮瓣血流障碍与缺血时间：随着皮瓣缺血时间的延长，血流障碍的发生率增加。在皮瓣缺血期间，肝素治疗皮瓣可抑制血流阻塞。(3)应用激光多普勒血流仪（LDF）观察游离组织移植口腔再造术后皮瓣的血流情况。术后皮瓣平均血流速度逐渐增加，至第3天趋于稳定。此外，在施用PGE 1后，皮瓣血流量增加30-40%，并且血流量的增加持续3-4小时。这样，术后皮瓣的血流变化，就被发现给出了一个统一的模式。另一方面，导致血流衰竭的患者术后血流模式各不相同。通过LDF对皮瓣的仔细监测可以为在皮瓣的宏观变化之前快速识别皮瓣中的循环障碍提供重要信息