自拟川黄三七汤防治自体移植静脉再狭窄的实验研究与护理配合

Study on the prevention of autologous vein graft restenosis by Cuanhuang-sanqi medicinal broth and clinical value of nursing cooperation

目的研究自拟川黄三七汤对兔颈外静脉移植至股动脉后再狭窄的防治作用,并探讨护理配合的意义价值。方法50只新西兰大白兔,随机分为实验组(川黄三七汤组)、生理盐水对照组。术前3d实验组开始采用灌胃法给予川黄三七汤,对照组给予等量生理盐水。每日一次,直至术后取材。所有动物建立自体静脉旁路移植模型:将颈外静脉端侧吻合于股动脉,术后取血管桥标本。光镜、扫描电镜观察近吻合口处和中央部静脉桥的管腔狭窄程度,统计学分析各组间差异。同时对术前准备、术中特殊用品的准备、手术配合及体会进行总结。结果移植4周后,各组静脉均有内膜及中膜较正常颈静脉明显增厚表现,辛伐他汀组,内膜及中膜增厚较对照组轻。两组静脉桥的管腔狭窄程度进行比较存在明显差异。结论川黄三七汤能抑制动脉化静脉内膜及中膜增厚,有减轻桥静脉狭窄的作用。护士熟悉手术步骤、配合熟练是实验顺利进行的基本保障。

Objective：To study the protective effects of Cuanhuang-sanqi medicinal broth on the external jugular vein after being transplanted into femoral artery and explore the clinical value of nursing cooperation.Methods： Autogenous vein grafts model was established in 50 rabbits.Interposition jugular vein was transplaced into carotid artery of the rabbits.Animals received Cuanhuang-sanqi medicinal broth.The control group given normal saline by oral gavage 72 hours before and then daily after surgery.grafting veins were sampled after 4 weeks.The veins were cut into 2 segments.One was for endothelial integrity grading by SEM examination.The other was interposed between contralateral common carotid arteries.Neintimal square-to-luminal square ratio（S1/S2） was measured with a computerized image analysis system.Value summary of the preoperative preparation,intraoperative preparation of special equipment,surgical support and experience.Results： The stenosis of grafted veins：4 weeks later,the jugular veins intima/media membrane of all the operative groups were significantly thicker than those in the normal control group.There were significant differences between every two group（P〈0.05）.Conclusion： Cuanhuang-sanqi medicinal broth can lessen the thickness of arterialized veins intima/media membrane and lighten the stenosis of the bridging vein.The animal can be benefited from successful operation as long as the surgery-participating nurses are very familiar with the surgical procedures and cooperate skillfully with the surgeons.