采用大鼠颈动脉进行显微血管吻合技术训练的可行性研究

Value of end-to-end rat carotid artery anastomosis in microtechnique training for beginners

目的探讨采用大鼠颈动脉进行显微血管吻合技术训练的意义。方法选取全国不同地域且未行显微血管吻合技术训练的神经外科医师71名。同时选取健康成年雄性SD大鼠142只,分为A、B两组(每组各71只)。受训医师先对A组71只大鼠行右侧颈动脉端端吻合术,之后2周内集中进行显微血管吻合技术训练;2周后再对B组71只大鼠行右侧颈动脉端端吻合。分别观测统计血管吻合时间(从开始缝合到缝合完成)、吻合针数、术后即时血管通畅率、术后24 h血管通畅率、术后存活率;并进行比较分析。结果A组有效完成实验大鼠57只,平均吻合时间为(45.1±6.23)min,平均缝合(6.1±1.42)针,术后即时血管通畅率为77.2%(44/57),术后24 h血管通畅率为46.4%(26/56),术后大鼠存活率为98.2%(56/57)。B组有效完成实验大鼠62只,平均吻合时间为35.3 min,平均缝合6.3针,术后即时血管通畅率为91.9%(57/62),术后24 h血管通畅率为57.4%(35/61),术后大鼠存活率为98.4%(61/62)。两组大鼠的平均血管吻合时间、术后即时和24 h通畅率的差异有统计学意义(均P<0.05)。结论采用大鼠颈动脉进行显微血管吻合技术训练,可显著提高初学者的血管通畅率,减少吻合时间;并且大鼠术后的存活率高,可作为初学者显微血管吻合技术训练的一种较好的动物模型。

Objective To explore the significance of using the rat carotid artery for microvascular anastomosis training.Methods A total of 71 neurosurgeons from different regions of China who did not undergo microsurgical anastomosis training were selected.142 healthy adult male SD rats(group A and B)were selected,and 71 rats in group A were performed with right end-to-side carotid anastomosis.The microvascular anastomosis technique was trained in 2 weeks.After 2 weeks,71 rats in group B underwent right CCA end-to-end anastomosis.The time of vascular anastomosis,the number of anastomotic needles,the vascular patency after operation,the patency of the vascular 24 hours after surgery,and the postoperative survival rate were measured.Results There were 57 subjects in group A,the anastomosis time was(45.1±6.23)min,the average suture was(6.1±1.42)needles,the immediate vascular patency rate was 77.2%(44/57),and the vascular patency rate was 46.4%(26/56)after 24 hours.Postoperative survival rate was 98.2%(56/57).There were 62 subjects in group B.The anastomosis time was 35.3 minutes,and the average suture was 6.3 needles.The immediate vascular patency rate was 91.9%(57/62),and the vascular patency rate was 57.4%(35/61)at 24 hours after operation.The survival rate was 98.4%(61/62).After statistical analysis,the difference between the two groups in the anastomosis time,immediate postoperative and 24h patency rate was statistically significant(all P<0.05).Conclusion Rat carotid artery microsurgical anastomosis training can significantly improve the vascular patency rate of beginners and reduce the anastomosis time.The survival rate of this model is high,and it can be used as a better training animal model for beginners.