实验性椎动脉显微手术的重建

THE MANEUVER AND RECENT EFFECTIVENESS OF EXPERIMENTAL VERTEBRAL ARTERY'S RECONSTRUCTION BY MICROSURGERY

目的:探讨椎动脉(VA)第一段(V_1)闭塞后显微手术重建的技巧及近期疗效。方法:对23只杂种犬夹闭二侧 VA 和一侧颈总动脉(CA)后实施同侧 VA 和 CA 端侧显微吻合术。以氢清除术测定局部小脑血流最(rCBF);超声多普勒、彩超检测 VA 血流速度及血流量;DSA 观察吻合口通畅程度。结果:吻合术后 rCBF 较 VA 闭塞后提高25%;VA 血流量,最高、最低流速较 VA 闭塞前分别提高131%、15%和87.8%;吻合口通畅,无侧支供血;动物全部成活。结论:该术式对提高 VA 血流、改善小脑组织血供疗效肯定,可能是一种治疗 V_1段 VA 闭塞性病变的有效方法。

Objective:To investigate the maneuver and recent effectiveness of vertebral artery (VA)reconstructing operation by microsurgery after occlusion of the first fragment of VA.Methods:A microsurgical anastomatic operation between VA and common carotid artery(CA)was performed on 23 dogs with clipped bilateral VA and unilateral CA.The regional cerebellum's blood flow(rCBF)was monitored by ways of Hydrogen clearance method;The blood flow velocity and volume of VA were measured by Ultrson Doppler and Color Ultrasonic Doppler;The anastomatic stomas were observed by DSA.Results:The rCBF after the anastomatic operation increased 25% than that of the occluded mod- el;the blood flow volume,maxima and minimal blood flow velocity in VA increased 131%,15% and 87.8% respectively;While the anastomosis was smooth and no collateral circulation was performed;All the dogs live now.Conclusion:This kind of surgical intervention could increase the blood flow volume of VA and hence improve the cerebellum's blood flow volume effectively.It may be one of the alternatives to treat the VA(V_1 fragment)occlusion patients.