应用新型血管吻合夹吻合血管后的血流动力学实验研究

HEMODYNAMIC CHANGES OF MICROVASCULAR ANASTOMOSIS WITH NITINOL CLIPS

目的 探讨镍钛合金血管吻合夹吻合血管后吻合口部的血流动力学变化。 方法 新西兰纯种成年大白兔 1 5只 ,随机分为吻合夹组、针线组和空白对照组 ,每组 5只。随机选取一侧颈动脉切断 ,吻合夹组以镍钛合金吻合夹行端端吻合 ;针线组行端端吻合 ;空白对照组分离出颈动脉后不做任何处理 ,关闭伤口。三组分别于术后 3、9、2 1及 30天 ,采用彩色多普勒超声诊断仪检测吻合口部平均血流速度 (Vm)、血管搏动指数 (PI)及血流阻力指数 (RI)三项血流动力学指标。 结果 术后 3、9天吻合夹组与针线组的血流动力学指标无统计学差异 (P>0 .0 5) ,术后 2 1、30天时两组Vm、RI均有统计学差异 (Vm分别为 P<0 .0 1 ,P<0 .0 5;RI分别为 P<0 .0 1 ,P<0 .0 5)。综合评价 ,吻合夹组的血流动力学指标恢复情况更接近空白对照组。 结论 镍钛合金吻合夹吻合血管后吻合口部血流动力学特征优于针线缝合法 ,吻合夹吻合血管快速、安全 ,且可靠 。

Objective To investigate the hemodynamic changes of the end to end anastomosed arteries with nitinol clips. Methods Fifteen New Zealand rabbits were divided into anastomosis clip group, suture group and control group randomly. The carotid arteries were resected and end to end anastomosis were carried out with nitinol clips in anastomosis clip group and with traditional suture in suture group. The carotid arteries remained undamaged in control group. On the days of 3, 9, 21 and 30 postoperatively, mean blood velocity (Vm), pulsatility index (PI) and resistance index (RI) of anastomosed arteries were determined by Ultrasonography Doppler. Results On the days of 8 and 9 postoperatively, there were no significant differences of Vm, PI and RI between two experimental groups ( P> 0.05). On the days of 20 and 30 postoperatively, the differences of Vm and RI were significant (Vm: P< 0.01, P< 0.05; RI: P< 0.01, P< 0.05). The hemodynamic restoration of the anastomosis clip group was better than that of the suture group. Conclusion The hemodynamics of arteries anastomosed with nitinol clips is better than that with traditional suture. This technique has practical value clinically .