三种激光小血管吻合术的实验病理学分析

Pathological Analysis of Laser-assisted Microvascular Anastomosis Experimental with Three Types of Lasers

健康SD大鼠80只随机分为三组，分别应用三种波长激光吻合颈总动脉共152条，平均直径Φ0.92±0.07mm。从术后1天至153天定时分批取三组血管标本行HE和弹力纤维染色后光镜观察。结果CO2、Ar+和Nd:YAG组血管通畅率分别为96.2％、97.8％和81.8％（P＜0.01）；吻合口处形成动脉瘤分别为3／53、4／44和1／55；管腔狭窄为1／53、4／44和4／55。各组损伤愈合过程相似，但三种激光焊接机理并非完全相同。作者讨论了激光小血管吻合术动脉瘤形成和影响通畅率等因素。认为毫瓦级CO2小血管吻合术较其它两组为优。

80 Sprague-Dawley rats were divided into 3 groups at random. End to end laser-assisted microvascular anastomosis (LAMA ) was performed on 152 carotid arteries, 0. 921±0.07mm in diameter, with CO2,, Ar+or Nd: YAG lasers. The duration of the observation ranged from 0 to 153 days. The pathological results were analysed with light microscopy by HE and Verhoeff stainings. The patency rates in CO2, Ar+ and Nd: YAG LAMA groups were 96. 2%, 97. 8% and 81. 8% (P＜0.01), aneurygrn occured in 3/53, 4/44 and 1/55,stenosis occured in 1/53, 4/44 and 4/55, respectively. The healing processes of the tisslle injuries in 3 groups were similar, but the mechanisms of LAMA might not be the same. The authors also discussed the factors influencing on LAMA aneurysm formation and patency, etc. They would consider that the mW CO2 LAMA may be better than the two others.