撕拉性离断血管损伤范围的实验观测

EXPERIMENTAL STUDY ON THE EXTENT OF INJURED BLOOD VESSELS IN AN AVULSION AMPUTATION MODEL

目的 测定撕拉性离断血管损伤的程度和范围。方法 大白兔 2 0只 ,随机分为切割性离断组 (A组 )和撕拉性离断组 (B组 )。以肉眼、手术显微镜、光镜和电镜测定每组动物血管损伤的程度和范围。分别于再植后3及 10天探查 ,统计通畅率并比较两组的愈合过程。结果 A组血管断端平齐 ,三层壁损伤范围一致 ,于断端 1mm范围以上管壁基本正常。 B组损伤重 ,内皮细胞缺失 ,内弹力层呈“跳跃样”破坏。在手术显微镜下观察正常部位以外 2～ 3mm仍有损伤。结论 撕拉性离断的血管损伤不规则 ,范围广。清创时应在显微镜下观察正常的部位外再切除 2～ 3mm,以保证管壁的完整。

Objective\ To measure the length and extent of the injured blood vessels in an avulsion amputation model. Methods\ Twenty rabbits were randomly divided into 2 groups. Group A was a sharp amputation group, and group B was an avulsion amputation group. The length and extent of the injured blood vessel was observed with naked eye, operation microscope and electronical microscope, and the limbs were replanted. Group A and B were explored at three days and ten days after the replantation respectively. The patency rate and healing process were compared. Results\ All the severed ends of vessels in group A were neat with almost the same injured range in the three layers of the vessel wall about 1 mm away from the severed end. The vessels of group B were damaged seriously, the end othelial cells were deleted. The “jumping like” damage could be observed in the elastic fibers. The injury of 2 to 3 mm away from the normal vessel wall could be observed by operation microscope. Conclusion\ The damage of avulsion amputation vessels was irregular, 2 to 3 mm or more tissues should be excised under the microscope in the process of operation in order to ensure the healthy intact blood vessel walls.