下腔静脉人工血管置换磁吻合术后观察

Anastomotic study of magnetic artificial blood vessel transplantation for caval reconstruction

目的:利用磁吻合(MCA)完成犬下腔静脉(IVC)人工血管置换,与传统缝合方法进行吻合口比较。方法:西安交通大学动物实验中心2018年9月至2019年2月提供成年家犬16只,编号后随机分为MCA组( n=8)与手工缝合(TMS)组( n=8),接受IVC部分切除后行人工血管置换,扫描电镜观察术后4、8、12周及24周吻合口内皮细胞生长情况,吻合口标本进行组织染色观察,并比较瘢痕增生程度。组间比较采用 t检验。 结果:电镜观察,MCA组人工血管吻合口内膜光滑,内皮细胞排列整齐,形态规则,TMS组吻合口内膜不完整,内皮细胞排列紊乱,形态不规则。组织学观察,MCA组吻合口血管壁对位整齐,血管内膜覆盖吻合口,术后12周吻合口呈慢性炎性反应,24周无明显炎性反应;TMS组吻合口缝线异物残留,瘢痕增生明显[(1.28±1.34) mm比(3.31±1.67) mm, t=4.115, P<0.05]。 结论:MCA组较TMS组人工血管吻合更理想,内皮细胞层光滑,无异物残留,炎性反应轻微。MCA技术实现下腔静脉人工血管置换效果可靠。

Objective To evaluate the performance of the magnetic compression anastomosis(MCA)device for caval reconstruction with artificial blood vessel transplantation compared with suture in canines.Methods Artificial blood vessel transplantation procedure was performed in sixteen canines and then they were divided into two groups of MCA group(n=8),in which the magnetic pinned-ring device was used,and the traditional manual suture(TMS)group(n=8).In situ artificial blood vessel anastomoses were performed in the inferior vena cava(IVC).The anastomotic quality were investigated through histological staining and scanning electron microscopy at 4,8,12,24 weeks postoperatively.Results The IVC were reconstructed successfully in all canines.Electron microscope scanning showed the re-endothelialization was smooth and endothelial cells arranged regularly at the anastomotic site.Histological examination confirmed that the magnetic device was associated with infiltration of inflammatory cells compared with the manual suture group[(1.28±1.34)mm vs.(3.31±1.67)mm,t=4.115,P<0.05].Conclusion Compared with manual suturing,the MCA was associated with smooth re-endothelialization,less fibrotic collagen deposition and depressed infiltration of inflammatory cells at the anastomotic site.The MCA device combined with artificial blood vessels is applicable in IVC reconstruction.