选择性髂内动脉结扎与栓塞对盆腔血供的影响

Influence of Selective Ligation and Embolization to Hypogastric Artery on Pelvic Blood Supply

目的：旨在探讨选择性髂内动脉结扎与栓塞两种方法对盆腔血供的影响。方法：将两组犬在膀胱上动脉分支以下之髂内动脉分别行结扎与栓塞，对比观察两组膀胱创面出血、盆腔动脉造影及盆腔脏器组织学变化，以确定其盆腔脏器的血供情况。结果：①结扎组膀胱创面出血明显大于栓塞组；②结扎组髂内动脉侧支循环建立时间明显早于且数目多于栓塞组；③两组盆腔脏器均未见缺血坏死。结论：栓塞组阻断髂内动脉侧支循环的数目多于结扎组，故对盆腔血供的影响大于结扎组。避免髂内动脉阻断范围过广可减少盆腔脏器缺血坏死的机会。

Objective:This study was to investagate the influence of selective ligation and embolization to the hypogastric blood on the pelvic artery supply.Methods:Before and after the hypogastric artery below the branches of the supperior vesical artery was seperately ligated and embolized in two groups of dogs,the blood loss during and after operation on bladder,angiography of the pelvic artery and pathology of pelvic organs were comperatively observed between the two groups to determine the blood supply to pelvic organs.Results:① The blood loss in the ligated group was much more than that in the embolized group (P<0.01);②The time in establishing collateral circulation of hypogastric artery in the ligated groups was ealier and its numbers were more than that in the embolized group;③ No ischemic change of the pelvic organs were found in both groups.Conclusion:The influence of selective embolization to the hypogastric artery on the pelvic blood supply are much remarkable than that of the selective ligation to it,because the numbers of collateral circulation of hypogastric artery in the embolized group are obstructed more than that in the ligated group.The ischemic and necrosis of the pelvic organs will be avoided if the collateral circulation are not obstructed too extensively.