医用胶黏合法吻合兔细小血管的实验研究

Experimental Study on Arteriolar Anastomosis with Medical Adhesive Method in Rabbits

目的探索医用胶黏合法行兔细小动脉血管吻合的可行性。方法新西兰兔12只,麻醉,暴露并切断双侧股动脉,按随机原则,一侧股动脉应用传统显微外科缝合法吻合(对照侧);另一侧应用可吸收缝合线血管外搭桥发挥牵引和支撑作用,α-氰基丙烯酸正丁酯医用胶黏合法吻合血管(实验侧)。比较两种吻合方法的操作时间、炎性细胞浸润数量及吻合血管后的血流速度变化。结果相比对照侧,实验侧所需手术时间少(P<0.001),吻合口炎性细胞少(P<0.01)。术后3 d、7 d,实验侧的血管通畅程度优于对照侧,差异显著(P<0.01),术后5周时两侧吻合口无明显差异(P>0.05)。结论缝线血管外支撑和牵引辅助下,以医用胶黏合血管断端,可缩短手术耗时,吻合口血管壁炎性反应轻,且通畅程度优于或不差于传统显微外科吻合法。

Objective To explore the feasibility of anastomosis of small arteries with medical adhesive in rabbits.Methods Bilateral femoral artery of 12 New Zealand rabbits were severed after anesthesia.One side of femoral artery was randomly selected and anastomosed with traditional microsurgical suture method as the control side.On the other side of the femoral artery,the absorbable suture line vascular external bypass was applied to play the role of traction and support,and theα-cyanoacrylate medical adhesive was used to anastomose the blood vessel,as the experimental side.The anastomosing time,intimal inflammatory reaction and changing of blood flow velocity were calculated.Results Compared with the control side,the operation time of the experimental side was less(P<0.001),and there were fewer inflammatory cells at the anastomotic site(P<0.01).At 3 days and 1 week after surgery,the anastomotic vessel patency of the experimental side was better than that of the control side,with significant difference(P<0.01),but the difference was not significant at 5 weeks after surgery(P>0.05).Conclusion The adhesive anastomosis with extravascular suture supporting is time-saving with mild inflammatory reaction of the vascular wall,and the anastomotic vascular patency is better or not worse than the traditional microsurgical anastomosis.