血管组织床对自体移植静脉影响的实验研究

EFFECTS OF DIFFERENT VASCULAR BEDS ON THE MICROSTRUCTURAL COMPONENTS AND INTIMAL HYPERPLASIA OF AUTOGENOUS VEIN GRAFTS IN DOGS

旨在探索血管组织床对自体移植静脉的影响。选１１只健康家犬，将其双侧股静脉倒置移植于同侧股动脉之间，行三定点褥式连续端端吻合，确认血管通畅后，分别置于健康肌肉内及皮下，观察两种条件下移植静脉的通畅情况，应用微机图像分析技术测量内膜增生程度及血管壁显微结构成分相对含量的变化。结果表明：①皮下组术后１周１条静脉发生假性动脉瘤，术后１６周２条静脉栓塞，肌肉组无合并症发生；②皮下组术后４周～１６周内膜增生趋势明显（Ｐ＜０．０５）；③移植血管壁显微结构成分相对含量两组无显著差异（Ｐ＞０．０５）。认为，皮下覆盖可能是导致移植早期血管过度扩张及移植后期血管内膜过度增生的重要因素。提示在临床上，应尽可能应用健康肌肉覆盖移植血管。

In order to investigate the effect of vascular beds on the vascular wall of autogenously grafted vein, femoral veins were reversely placed in between the cut ends of collateral femoral arteries in 11 dogs with atraumatic technique. The grafted veins were covered with vivid muscle or skin respectively after being assured to be patent, and investigated by histomorphologic method and computerized image analysis technique at postoperative intervals of 1 week, 4 weeks and 16 weeks. The results showed that: ① one graft developed pseudoaneurysm at 1 week, and two grafts were occulded in skincovered group, whereas, no complications occured in musclecovered group. ② intimal thickening of grafts in skincovered group was much more obvious than that in the musclecovered group (P<0.05). ③ the relative contents of microstructural components of the graft wall showed no significant difference quantitatively between the two groups. So, the conclusion was: ① subcutaneous transplantation appeared to be a potential causative factor in inducing shortterm excessive dilatation and longterm intimal hyperplasia of vein graft. ② muscular covering is of priority in blood vessel graft.