中文摘要：

目的 观察皮瓣延迟术对大鼠三血管体穿支皮瓣成活的影响并探讨其可能机制，方法 本实验采用大鼠背部右侧以旋髂深动脉为蒂的三血管体穿支皮瓣模型,将3个血管体之间的2个交界区域由皮瓣蒂部开始以远依次命名为闭塞区域1、闭塞区域2.按随机数字表法将110只SD大鼠分为常规皮瓣组40只、单纯延迟组30只、延迟皮瓣组40只，（1）于常规皮瓣组中,按随机数字表法选取30只大鼠直接行皮瓣手术,术后0（即刻）、1、2、3、7d分别处死6只,取2个闭塞区域全层皮肤组织行HE染色检测血管密度及外径.剩余10只大鼠颈外静脉置管后行皮瓣手术,从术后0d（5只）或术后1d（5只）开始每隔2d注射1.5 mL荧光素钠（100 g/L）观察皮瓣血运变化,每只注射4次;术后7d,计算10只大鼠皮瓣成活率,采用改良氧化铅-明胶灌注法行血管造影观察皮瓣内血管形态与分布，（2）单纯延迟组大鼠仅通过局部皮肤小切口手术结扎右侧胸背动脉,术后0（即刻）、1、2、3、7 d分别处死6只大鼠同常规皮瓣组部位取皮肤标本测量血管密度及外径.（3）延迟皮瓣组大鼠按单纯延迟组术式行延迟手术,术后7d按与常规皮瓣组相同的方法选取、分配及处理本组所有大鼠并检测相应指标.对数据行成组样本t检验、析因设计方差分析、SNK检验， 结果 （1）3组间比较,术后7d闭塞区域1、闭塞区域2血管密度差异均明显（F值分别为2.69、2.76,P值均小于0.05），延迟皮瓣组大鼠术后7d闭塞区域1、闭塞区域2血管密度分别为（29±7）、（31±8）个/mm^2,显著高于常规皮瓣组的（23±5）、（23±3）个/mm2（q值分别为5.67、6.01,P值均小于0.05）,且显著高于组内术后0d水平（q值分别为6.42、7.14,P值均小于0.05），术后3、7d,常规皮瓣组、延迟皮瓣组大鼠闭塞区域1血管外径显著高于单纯延迟组（q值为8.15～11.13,P值均小于0.05）;延迟皮瓣组

英文摘要：

Objective To observe the effects of surgical delay procedure on the survival of perforator flap with three angiosomes in rat,and to explore its possible mechanism.Methods The flap model was a perforator flap with three angiosomes which located on the right dorsal side of a rat based on thc right deep circumflex iliac vessel.The two connection areas between the three angiosomes were successively named choke zone （CZ） 1 and CZ 2 beginning from the pedicle to the remote area.A total of 110 SD rats were divided into routine flap group （RF,n =40）,delay only group （DO,n =30）,and delay flap group （DF,n =40） according to the random number table.（1） In group RF,30 rats were selected according to the random number table,and flap surgery was performed directly.Six rats were sacrificed on post operation day （POD） 0,1,2,3,7 respectively to collect the full-thickness skin samples at both CZs for HE staining to measure the vascular density and diameter.The rest 10 rats underwent flap surgery immediately after a catheter was successfully implanted into their external jugular vein.A volume of 1.5 mL sodium fluorescein solution （100 g/L） was injected to the 10 rats on POD 0 （5 rats） or POD 1 （5 rats） each time with a 2-day interval to learn the change in flap circulation.Each rat was injected for 4 times.The flap survival rate of the 10 rats was calculated on POD 7,and the configuration and distribution of the vessels in the flap were observed through angiography with the improved perfusion method of lead oxide-gelatin.（2） In group DO,the right thoracodorsal perforators of all the rats were surgically ligated through a small skin incision,and 6 rats were sacrificed on POD 0,1,2,3,7 respectively.The skin samples of each rat at the same area as in group RF were harvested to measure the vascular density and diameter.（3） In group DF,rats were treated with ligation surgery as in group DO,and then they were assigned and treated as in group RF on POD 7 with corresponding indexes detected later.