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目的:观察125Ⅰ粒子对血管吻合口及游离皮瓣愈合状况的影响,探讨晚期头颈肿瘤患者,行游离皮瓣修复的同时,植入125Ⅰ粒子内放疗的可行性。方法:45只新西兰大白兔,游离双侧下腹部皮瓣,左右交换,吻合血管,缝合皮瓣。左侧植入125I粒子归入实验组,右侧植入无活性粒子归入对照组。随机取15例大白兔分别于术后2周、4周、10周处死,切除皮瓣及吻合口处血管,进行大体及组织学观察。结果:实验组与对照组相比,皮瓣存活率,光镜下皮瓣单位面积毛细血管数量无统计学差异;血管吻合口畅通率基本一致,内膜、中膜厚度在2周观察对象中无统计学差异的改变,4周、10周实验组血管内,中膜的增生厚度明显减低。结论:本实验剂量下125Ⅰ粒子的植入放疗,不会对血管壁产生不可逆的损害,并在一定程度下减轻血管吻合口内、中膜的过度增生;对游离皮瓣本身血运的重建不会产生明显的负面影响。
OBJECTIVE: To observe the effect of 125I particles on the healing of vascular anastomotic and free flap, and to explore the feasibility of 125I particle radiotherapy in patients with advanced head and neck cancer while free skin flap was repaired. Methods: Forty-five New Zealand white rabbits were divided into bilateral lower abdomen flaps, exchanged left and right, anastomosed blood vessels and sutured skin flap. The left 125I seeds into the experimental group, the right of the inactive particles into the control group. Fifteen rabbits were randomly selected and sacrificed at 2 weeks, 4 weeks and 10 weeks after operation respectively. The flaps and the anastomotic vessels were resected for gross and histological observation. Results: Compared with the control group, the survival rate of the flap and the number of capillaries per unit area under the light microscope showed no significant difference between the experimental group and the control group. The anastomotic rate of the vascular anastomosis was basically consistent. The thickness of intima and media was No statistically significant change, 4 weeks, 10 weeks experimental group vascular, mesothelial hyperplasia thickness was significantly reduced. CONCLUSION: Irradiation of 125 I seeds under the dose of this experiment will not cause irreversible damage to the vessel wall, and to a certain extent reduce the hyperplasia of the vascular intima and media in the vascular anastomosis. The reconstruction of the free flap itself will not Have a significant negative impact.