带血管髂骨移植动物模型的建立与评估

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P0.05),而静脉吻合时间、缺血时间,供受体准备时间并无差异(均P0.05)。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。

Establishment and Evaluation of Vascularized IliumTransplantation Animal Model

Objective:To explore a relatively simple, stable way of ilium osteocutaneous flap transplantation in rats, for establishing a reliable animal model of chimerism induced by ilium transplantation.Methods:The experiment was divided into three groups, blank control group without any treatment; traditional surgery group in which the donor''s ilium myocutaneous flap was transplanted in the recipient''s groin area and the iliolumbar artery and iliolumbar vein of the donor pedicle was anastomosed with the femoral artery and vein of the recipient; experimental group, in which the gluteus maximus was striped, and the donor''s iliac which jointed muscle and skin flap was transplanted in the recipient''s groin area, and the common iliac artery and iliolumbar vein of the donor pedicle was anastomosed with the femoral artery and vein of the recipient. Following transplantation, immunosuppression protocol of cyclosporine A monotherapy was used for 28 days with the dosage of 16 mg/kg/d in the 1st and 2nd week, tapered to half dosage weekly at the beginning of 3rd week. After 28 days the rats were killed and the iliums were selected for pathological examination. The amount of the bone marrow cells and bone cell in bone lacuna was observed to determine whether the iliums survived.Results:Fifteen transplantations were performed in the experiment group and 11 flaps survived with a successful rate of 73 %. Pathological examination showed subcutaneous iliums of 7 cases survived, with a successful rate of 47 %.Eight transplantations were performed in the traditional surgery group and 4 flaps survived with a successful rate of 50 %. Pathological examination showed subcutaneous iliums of 3 cases survived, with a successful rate of 37.5 %. The durations of arterial anastomosis in the experimental group was (24.7± 2.3) min which was significantly less than (36.7± 1.5) min in traditional surgery group (P<0.05). But the time of venous anastomosis, ischemia time, donor and recipient preparation time had no difference (all P>0.05).Conclusion:Fromstriping gluteus maximus and changing the object of artery anastomosis, we can set up a relatively simple and stable iliumflap transplantation mode and provide a new animal model which can be used to explore the chimeric state induced by the vascular bone marrow transplantation.