兔静脉动脉化对腓肠肌组织结构影响的观测及临床意义

The Clinic Significance and Effect of Arterialized Vein on Tissue Structure of Gastrocnemius

目的观察完全与不完全离断兔小腿静脉动脉化后腓肠肌组织结构的变化规律,并与传统断指(肢)再植手术成活的腓肠肌组织进行比较,为临床选择断指(肢)再植手术方式及治疗肢体缺血症提供实验依据。方法用15只兔分3组:A组为完全离断小腿胫后动脉缝接胫后静脉动脉化组;B组为部分离断小腿胫后动脉缝接胫后静脉组;C组为完全离断小腿应用传统的胫后动脉缝接胫后动脉对照组。3组均结扎胫前动脉,保留胫前静脉等未动脉化的静脉及缝接其它组织结构。术后28d麻醉下切取各组腓肠肌内侧头制成标本,经HE、Mallory、PCNA、肌动蛋白、Ⅰ型胶原蛋白、琥珀酸脱氢酶、vitc等染色和HYP含量测定等方法处理后进行光学显微镜观测。结果AB组明显可见腓肠肌的肌纤维变细变少,肌动蛋白含量减少,PCNA阳性,肌卫星细胞增多,白肌纤维为主的腓肠肌肌纤维转变较多的红肌纤维等变化,Mallory染色示肌纤维间隙变大,结缔组织增生。C组变化明显少于AB组。结论静脉动脉化有利于减少离断腓肠肌等组织结构萎缩和变性。

Objective To observe the effect of arterialized vein on tissue structure of gastrocnemius for completely and uncompletely transected posterior limb of rabbit to obtain the evidence for selecting the surgery style to replant cut off fingers（limbs） and low down the shrink back and denature. Methods Fifteen rabbits were divided into： posterior limbs completely cut off and posterior tibia artery ligated with posterior tibia vein（A group）, posterior limbs uncompletely cut off and posterior tibia artery ligated with saphenous vein （B group）, posterior limbs completely cut off and traditional operation style applied to ligate the posterior tibia artery with posterior tibia artery （C group）. The anterior tibia artery was ligated, anterior tibia vein and the other soft tissue were seamed for all groups. 28 days later, gastrocniums of all groups were cut off and observed by HE, Mallory, PCNA staining, actin stainning, Amber acid dehydrogenase staining, vite staining and HYP content mesuration by light microscope. Results The fibers of gastrocnemius were slimmer and less in number, less actin protein and PCNA positive staining, and more satellite cells of muscles in group A and group B than in group C, with white muscle fibers in gastrocnemius turnning into red muscle fibers and the larger muscular space and more connective tissue hyperplasia in group A and group B than in group C. Conclusion Arterialized vein was a useful method to decrease the amyotrophy and denature of gastrocnemius fibers.