脐动脉预作为桥血管移植材料的生理解剖研究

Physiologicoanatomical study of fetal umbilical artery as vascular graft in coronary artery revascularization

目的：从脐动脉生理解剖方面探讨脐动脉作为冠状动脉血管移植材料的可行性。方法：采用血管超声检测35例孕龄约37～40周的胎儿在体脐动脉的内径；血管物理性能检测观察血管的顺应性及耐压性能；观察液压扩张技术对脐动脉解剖结构的影响。结果：在体脐动脉的内径为（3．47±0．36）mm，血流流速为（54．64±8．36）cm／s。血管物理性能检测发现脐动脉有良好的顺应性，而且具有良好的耐压性能（爆破压〉300mmHg）（1mmHg=0．133kPa）。由于脐动脉肌层发达，有自闭趋向，遂采用液压扩张技术增大脐动脉121径，使血管失去回缩作用；而且该实验发现液压扩张不引起血管解剖结构的明显损伤。结论：1．脐动脉从生理解剖方面具备作为冠状动脉搭桥血管材料的基本条件；2．液压扩张可增大脐动脉口径，预防痉挛发生，且不引起血管结构的明显损伤。

Objective： To study the feasibility of using umbilical artery （UA） in coronary artery revascularization from physiologicoanatomical aspect. Method： The internal diameter of UA is measured by ultrasonicangiography in 35 pregnant women. One hundred fifty UAs were harvested from placenta 4 to 6 hours after the birth of the fetuses. Vascular compliance and pressure-endured capacity was measured. The effect of liquid pressure dilatation on the structure of the UA was studied. Result： UA＇s internal diameter is （3.47 ± 0.36） mm. The flow velocity is （54.64 ± 8.36）cm/s. The vascular mechanical examinations show that UA has nice compliance and high pressure-endure capacity（the burst pressure〉 300 mmHg）. Because the abundant muscle, UA had the tendency of serf-occlusion. Liquid pressure dilatation was used to augment the diameter of UA which make UA lose the ability to retract. Conclusion： UA can be used as vascular graft materials in coronary artery revascularization on aspect of physiologicoanatomical study. Liquid pressure dilatation can augment the diameter of UA, which can avoid vascular spasm, but do not damage the vessel.