动脉化疗联合同期放疗对微血管吻合影响的实验研究

Effects of intra-arterial perfusion of cisplatin combined with concomitant radiation therapy on the healing of microvascular anastomoses: An experimental study in rabbits

目的:研究动脉化疗联合同期放疗对微血管吻合的影响。方法:新西兰大耳白兔20只,按每只腿股动脉处理方法不同分为4组:对照组、化疗组、放疗组和化放疗组,分别给予动脉灌注生理盐水、动脉灌注顺铂、动脉灌注生理盐水+25Gy放疗、动脉灌注顺铂+25Gy放疗。上述处理结束1周后,行双侧股动脉横断吻合术,观察以上处理对动脉管壁结构,以及对吻合后血管通畅率的影响。结果:以上处理可造成动脉管壁结构的改变,主要表现为内膜及中膜的慢性损伤,其中以化放疗组损伤最为严重,放疗组、化疗组及对照组的改变依次减轻。虽然管壁结构出现损伤改变,但是对吻合后的通畅率没有影响。结论:术前动脉灌注顺铂、25Gy放疗以及动脉化疗联合同期放疗后的血管,可以作为受区血管行游离皮瓣移植。

PURPOSE： To investigate the effects of intra-arterial perfusion of cisplatin and concomitant radiation therapy on the microvascular structure and the healing of anastomoses. METHODS： Three different treatments including intra-arterial perfusion of saline, intra-arterial perfusion of cisplatin, intra-arteriaf perfusion of saline and 25 Gy radiation therapy as well as intra-arterial perfusion of cisplatin and 25Gy radiation therapy were conducted in 40 femoral arteries of 20 rabbits,which divided into 4 groups,control group,intra-arterial chemotherapy group,radiation therapy group and combined treatment group accordingly. The bilateral femoral arteries were transected and anastomosed using microsurgical technique on 7^th day after the treatments were completed. The effects of different treatments on the microvascular structure and the pateney rates of anastomoses were investigated. RESULTS： The evidences of chronic damage to the vascular wall were observed in 4 groups. The changes in the combined treatment group were most serious. The damage to arterial wall in the radiation therapy group, chemotherapy group, and control group decrease gradually in order. Although the damages of the vascular wall were observed, there were no differences in the patency rates after microvascular anastomoses. CONCLUSION： These vessels can be used with caution as recipient vessels for free tissue transfer.