生物可吸收性人工血管诱导幼猪上腔静脉再建

Bioresorbable synthetic conduit induced reconstraction of superior vena cavain pig

目的:为了尝试克服目前用于心血管手术的人工材料不具有生长性等缺点,在幼猪体内评价了细胞种植,机体自孵化修饰后的生物可降解聚羟基乙酸人工血管(PGA)移植于静脉系统的可行性。方法:22头幼猪被分为两组,在实验组PGA人工血管用切碎的皮下结缔组织脂肪组织涂抹后插入直径10 mm的硅胶管,埋入皮下1周后移植入幼猪上腔静脉。对照组PGA人工血管移植前用新鲜血预凝。结果:实验组4周、8周1、2周、24周的开通率分别为100%(8/8)、85%(5/6)、75%(3/4)、100%(2/2)。在第4周、第8周、第12周有不同程度的狭窄,但逐渐减轻,第24周内径接近受体人腔静脉,再建血管的长度有所增加。对照组4周、8周1、2周2、4周的开通分别为50%(4/8)、50%(3/6)、25%(1/4)、0%(0/2)。结论:PGA人工血管直接移植入上腔静脉很难获得理想的长期开通率,实验组显示了相对理想的开通率及再建和生长的潜能,提示细胞种植,机体自孵化修饰后的PGA人工血管以具有生长潜能的特点有望用于低压血管的移植。

Objective：In an attampt to overcome the disadvantages of currently available conduits,such as lack of growth potential,we evaluated the teasibility of a biodegradable synthetic （polyglycolic acid,PGA） conduit in pig model. Methods：22 pings were divided into two groups. In the experimental group ,the synthetic conduits daubed with thin subcutaneous tissue fragment were inserted by silicone tubes （10 mm in diameter）,then implanted into under skin for one week. In control group,the synthetic conduits were preclotted with fresh blood just before replacement into SVC. Results：In experiment group,the patency rates at 4,.8,12 and 24 weeks were 100%（8/8）,85%（5/6）,75% （3/4）, 100（2/2）respectively. The degree of stenosis showed degression at 8,12 weeks compared with that at 4 weeks. The diameter of the reconstructive vessels in near the diameter of the SVC. The lengths of reconstructive vessels appeared to be increase at 24 weeks. In the control group,the patency rates at 2,4,8,and 24 weeks were 100%（3/3）, 50% （2/4）,0% （0/3）,0% （0/2）respectively. Conclusion：The direct replacement of PGA conduit in SVC was difficult to require ideal pateney rate of long term. The PGA conduits of the experiment group showed relative ideal patency rates and the growth,remodeling potential,which suggest PGA conduit with seeding basioeell and self-culture to be available for the vessels of low blood pressure.