动-静脉分流维持静脉吻合口通畅率的实验研究

AN EXPERIMENTAL STUDY ON THE EFFICIENCY OF ARTERIOVENOUS SHUNT IN MAINTAINING THE PATENCY OF VENOUS ANASTOMOSIS

将30只大白鼠两侧髂外静脉均结扎(模拟血栓阻塞),并以旋髂深静脉行旁路转流术。左侧为对照组。右侧在转流静脉远侧辅建旋髂深动脉-髂外静脉分流术,设为实验组。结果实验组旋髂深静脉转流术吻合口通畅率在术后各期均高于对照组(P<0.01)。表明动-静脉分流可促进静脉血流速度和流量,降低血小板和纤维蛋白的沉积,提高静脉转流术吻合口的通畅率。静脉转流的移植物口径应足够粗,动-静脉分流术吻合口应适当小些(流经吻合口的血流量以100～300ml/min为宜)。恰当的动-静脉分流可长期保留。

On the basis of ligation of the bilateral external iliac veins in 30 rats to imitate thrombotic occlusion, venous bypasses were reconstructed using deep circumflex iliac veins. The left side was designed to be the control group, while the right side the experimental group in which adjunctive distal arteriovenous shunt (AVS) through deep circumflex iliac artery was performed. The patent rate of the venous bypass after operation was much higher in the experimental group than in the control group. Distal AVS can increase blood flow through the venous bypass, decrease the platelet and fibrin deposition and enhance the patency of the bypass graft. Combining the result with clinical experience, the authors are of the opinion that the orifice of venous bypass graft should be large enough and the anastomosis of AVS should be appropriate (blood flow in AVS maintaining within the range from 100 to 300 ml/min).