组织黏合剂注入成兔动脉与静脉内的组织病理学研究

The histopathological representation of vessels after injection of N-butyl-2-cyanoacrylate

目的探讨组织黏合剂注入成兔血管后的组织病理学改变，阐明其止血机制及作用过程，指导临床应用。方法在42只新西兰成兔的颈外静脉和股动脉内注入组织黏合剂0．2ml，分别在注射后3天、7天、2周、3周和4周、2月和3月取材进行组织病理学研究。结果①成兔血管内注入组织黏合剂可即刻有效闭塞血管；②组织病理学主要表现3天～2周为急性炎症反应，3周逐渐发展为亚急性血管炎、4周为慢性肉芽肿异物反应，2月～3月胶块基本消失，取代为纤维组织，部分血管再通；③3周时动脉管壁弹力纤维明显增生，管腔变小闭塞，而静脉管壁仍表现为炎症坏死，未发现弹力纤维增生；④静脉与动脉均出现排胶现象，静脉更明显。结论成兔静脉与动脉注射后的组织病理学表现相似，不同在于2～3周时动脉管壁弹力纤维明显增生，静脉仍为炎症坏死；静脉与动脉均出现排胶现象。

Objective To investigate the structure and pathological representation after injection of N-butyl-2- cyanoacrylate. Methods Mixtures of 0.2ml cyanoacrylate and lipiodol was injacted into cervical veins and femoral arteries of rabbits. The animals were equally divided into seven groups （6 animals each） according to the planned survival intervals of 3 days, 7 days, 2 weeks, 3 weeks, 4weeks, 2 months and 3 months. Histological changes and difference between arteries and veins were observed. Results We observed the acute inflammatory reaction at 3 days after injection, and then gradually developed into chronic granulomatous foreign body reaction. The elastic fibrin in arterial wall proliferated distinctly after 3 weeks resulted into the smallness of cavity. However there were inflammation and tissue necrosis in venous wall. We observed extrusion of glue in both arteries and veins. Conclusion The histopathological behavior is acute inflammatory effect within two weeks, then chronic granulomatous foreign body reaction at second month and fibrosis finally. There is mainly inflammation in veins without the proliferation of elastic fibrin.