用犬股静脉移植修复股动脉缺损后动态增殖研究

Investigate the proliferation after transplanted femoral vein repair defective femoral artery in dogs

目的以杂种家犬为实验对象,用手术的方法建立股静脉替代股动脉的实验模型,探讨股静脉移植修复动脉缺损后的微细结构增殖性改变及其随时间改变的变化程度,找寻静脉替代动脉后的增殖规律。方法股静脉倒置移植修复动脉缺损,术后30～180 d分6个时间段行血管造影观察通畅率并分别切取移植静脉,肉眼和光镜观察自体静脉移植后的内膜、中膜增殖情况。结果血管造影显示移植静脉管腔变细,管壁增厚,都有不同程度的僵硬变厚,弹性减低,光镜下管腔面内皮细胞层随时间延长由扁平状逐渐变为柱状,中膜平滑肌层数增多。结论自体静脉移植入动脉环境后时间越长,移植血管管壁就越厚,管腔就越狭窄,闭塞的几率增加。术后60 d为移植静脉管壁增殖的开始时期。

Objective To investigate the proliferation rule after autograft vein in autograft of vein and repairing arterial defect, discuss the minuteness structure changes related to time, and provide morphological date for the prevention and treatment of restenosis in clinic application. Methods Sixty canine femoral veins （3.5 cm and 5.5 cm） were excised, reversed and grafted to repairing femoral arterial defect using end- to-end anastomosis. During the period of 30 - 180 days excised the grafted veins, observed ultrastrural changes of endothelium, microstructural components relative content and patency in grafted veins through angiography, lipht microscope. Results Angiography show that the grafted vein wall get gradually thicker, vascular cavity get slender, and vessel elasticity shrinkage. Light microscope chalrify the uhrastructural changes of endothelium, the three lamine structure of grafted vascular wall could not be identified. Conclusion Grafted femoral veins had obviously arteriosclerosis trend after it was transplanted to the arterial system. Two months after the transplantation is the crisis time of the proliferation of the vascular wall. The effect of the proliferation of the grafted veins vascular wall and the impact of the hi-pressure of blood can lead some canine ruptured to die from pseudoaneurysms.