摘要
目的研究冷循环微波天线对人离体曲张大隐静脉腔内的作用机制。方法术中切取下肢大隐静脉曲张患者的大隐静脉主干,直径(6.5±0.5)cm,将其分成每段长10cm,两端细线结扎,腔内注入5ml生理盐水。对照组2组,每组2段;实验组4组,每组12段。将冷循环微波天线插入静脉腔中,分别以不同输出功率(0W、30W和35W)与不同退出速度(5cm/min和10cm/min)退出。用苏木精-伊红染色和透射电镜观察静脉壁的内膜,弹力纤维、胶原纤维、平滑肌细胞和血管外周围组织的病理改变,用游标卡尺测量管腔外径的变化。结果内膜损伤率:对照组和30W×10cm/min组无内膜损伤,30W×5cm/min组为25%,35W×10cm/min组为91.67%,35W×5cm/min组为100%,后两组与第1组差异均有统计学意义(P<0.05),后两组间差异无统计学意义(P>0.05)。外膜损伤率:35W×5cm/min组为41.67%,其余组均无外膜损伤,与对照组差异有统计学意义(P<0.05)。管腔缩小率:对照组无管腔缩小,30W×10cm/min组为(31.67%±2.16)%,30W×5cm/min组为(36.44%±2.42)%,35W×10cm/min组为(50.60±0.39)%,35W×5cm/min组为(56.62±1.23)%,各组间差异均有统计学意义(P<0.05)。病理观察和电镜结果显示内膜损伤组的内皮细胞变性坏死、脱落,内膜断裂完整性破坏,肌纤维、胶原纤维变性、挛缩,排列紊乱。结论冷循环微波天线能损伤曲张大隐静脉内膜,内膜损伤率随输出功率的增加而升高,随退出速度减慢而增加。35W×10cm/min为最佳组合,既保持高内膜损伤率又避免了外膜损伤。30W×10cm/min能使静脉管腔缩小约30%,但不损伤内膜。
Objective To study the mechanism of endovenous CCMA to vitro great saphenous vein.Methods The great saphenous veins(GSV) from clinically operation were divided into two control groups and four experimental groups randomly.The GSV was ligated at two extrs and infused physiologic saline in the intracavity.The CCMA inserted in the GSV was pulled out with the different powers(0W、30W and 35W) and the different velocities(5cm/min and 10cm/min).The GSV was investigated the morphological changes of tissue by HES and TEM and observed the changes of lumens by sliding caliper.Results The injury rates of intima examined by LM in 30W×5cm/min、35W×10cm/min and 35W×5cm/min group were 25%、91.67% and 100% respectively and that was 0% in the control group and 30W×10cm/min group.There was significant difference between 30W×5cm/min and 35W×10cm/min group(P0.05).The injury rates of extima in 35W×5cm/min and the other group were 41.67% and 0% respectively,there was significant difference between them(P0.05).The minification of lumens examined by sliding caliper in 30W×10cm/min 、30W×5cm/min、35W×10cm/min and 35W×5cm/min group were(31.67±2.16)% 、(36.44±2.42)% 、(50.60%±0.39)% and(56.62±1.23)% respectively,there was significant difference between them(P0.05) and that was 0% in control group.HE staining and TEM showed that cell degeneration and necrosis,destroyed intima and contracture collagen fibers in the injury groups.Conclusion Endovenous CCMA can damage the intima of GSV and make the venous lumens minification.
出处
《四川医学》
CAS
2011年第11期1685-1688,共4页
Sichuan Medical Journal
关键词
微波
静脉
腔内
影响
体外
microwave
vein
endovenous
effect
vitro