动脉原位扩张即时延长的实验研究

Experimental study of acute intraoperative arterial elongation

目的 观察动脉快速延长对血管壁的影响 ,研究创伤性动脉缺损新的修复方法。方法 选用12只杂种犬 ,对 2 4条股动脉进行急性延长 ,分别于术后 1、7和 2 8d行延长段血管组织学、免疫组化和超微结构观察。结果 各组血管腔通畅率为 10 0 % ;延长段血管内膜光滑 ,中膜损伤轻微 ,各时间点胶原纤维与弹力纤维含量及其比值差异无显著性。动脉吻合后吻合口段顺应性降低 ;增殖细胞核抗原阳性细胞百分率峰值小于2 0 % ;吻合口和扩张段内、外径组间差异均无显著性。总体比较缺损组和手术对照组组织学改变差异无显著性。结论 动脉缺损通过低压球囊扩张在有限张力存在下延长吻合是一种简单、安全、有效的治疗手段 ,可以部分替代静脉和人造血管移植 ,急诊情况下更具有实用价值。

Objective To investigate the effect of arterial elongation on the arteries and to set up a new method for vessel repair. Methods This study was performed in 24 arteries that underwent different traumatic deficit and acute intraoperative elongation repair. The vessels were harvested and studied by histology , electron microscopy, and immunohistochemistry on day 1, 7 and 28 after operation. Results The total unobstructed rate was 100% for deficit group as well as control experimental group. The content of collagen and elastin at various intervals showed no significant difference, the ratio of them also had no significant difference. Following anastomosis, the compliance of arteries was decreased, the peak value of proliferative cell nuclear antigen(PCNA) positive cell percentage was less than 20%, the internal diameter of elongation and anastomosis edge had no significant difference between deficit group and control group. There were no marked differences in pathological changes between deficit group and control group. Conclusion Acute intraoperative artery elongation after balloon dilatation is a simple, safe, and effective alternative to vein interposition in the repair of traumatic arterial injuries. It appears to be a useful method in the emergency treatment.