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目的：研究术后放疗对游离皮瓣移植后病理变化的影响，为临床提供参考。方法：采用３０只新西兰白兔制作双侧耳背皮囊，术后３周分别行７Ｇｙ，９Ｇｙ，１３Ｇｙ×４次／ｗ的６０Ｃｏ照射，放疗后不同时间内进行大体观察以及病理血管铸型检测。结果：中低剂量组３２例皮瓣全部存活，高剂量组有５例（３１．２％）发生坏死。微血管铸型显示轴血管通畅，但高剂量组皮瓣微血管密度明显降低。结论：游离皮瓣对于临床常规剂量（＜７０Ｇｙ）术后放疗具有良好的耐受性，高剂量放疗时（＞９０Ｇｙ）应慎重对待，微血管系统的破坏是皮瓣放射性损害的重要病理环节。
Objective: To study the effect of postoperative radiotherapy on the pathological changes after free flap transplantation, and provide reference for clinical application. Methods: 30 New Zealand White rabbits were used to make double-sided ear dorsal sac. Three weeks after operation, 7Gy, 9Gy and 13Gy × 4 times / w 60Co irradiation were performed. Gross observation and histopathology were performed at different time after radiotherapy. RESULTS: Thirty-two flaps survived in the medium and low dose groups, and necrosis occurred in 5 (31.2%) in the high dose group. Microvascular cast showed axial vessel patency, but the microvascular density in the high dose group was significantly reduced. CONCLUSION: The free flap is well tolerated by postoperative radiotherapy in clinical routine doses (<70 Gy). It should be treated with caution in high-dose radiotherapy (> 90 Gy). The destruction of the microvascular system is an important pathological link of radioactive lesion of the flap.