组织黏合剂闭合血管影响因素的血液流变学研究

Study on the actual mechanism of N-butyi-2-cyanoacrylate in vessels

目的通过血液流变学研究组织黏合剂 N-丁基-2-氰丙烯酸盐在模拟血管中的实际行为,分析影响其闭合血管的主要因素,找到发挥作用的最佳条件。方法利用聚四氟乙烯管建立血流模拟装置,分别研究血管直径、血流速度以及组织黏合剂配比浓度这三个因素对组织黏合剂闭合血管的影响。结果组织黏合剂与碘油1:1配比混合物1.0 ml 快速注射至聚四氟乙烯管内可以完全阻塞血流速度15 cm/s、直径0.4 cm 的以及血流速度10 cm/s 且直径0.6 cm 的血流。当管腔直径增加至0.8 cm 或血流速度加快为20 cm/s 时,血流只是部分闭塞。改变组织黏合剂与碘油配比为0.5:0.8以及0.5:1.0,则注射后聚合体断裂成碎片状。结论实验验证了随着血管直径增大、血流速度加快及配比浓度降低,组织黏合剂闭合血管的效应下降,以供临床定量参考。

Objective To study on the actual mechanism of N-butyl-2-cyanoacrylate in vessels, and find out the most important and appropriate factor and demand. Methods Vinyl tubes were used to create varix model, a volume of 1.0 ml of cyanoacrylate was injected into vinyl tubes of 0. 4, 0. 6 and 0. 8 cm in diameter, which were filled with flowing blood. Effect of the vessel diameter, the blood velocity and the matched concentration of cyanoacrylate and lipiodol on the process of blood polymerization was investigaled. Results A volume of 1.0 ml of the mixtures of cyanoacrylate and lipiodol （ 1： 1 ） could completely block the blood stream with 15 cm/s in velocity and 0. 4 cm in diameter or with 10 cm/s in velocity and 0. 6 cm in diameter. With＇the increase of diameter and velocity, it can block vessel incompletely and required to increase the dosage of mixture. When the matched concentration was changed, the effectiveness decreased, and some polymer masses were fragmented. Conclusion The polymerization of cyanoacrylate was affected by vessel diameter, blood velecity and matched concentration of mixtures. These factors should be considered in clinical practice.