兔缺血后肢静脉动脉化后远端形态学及微循环的改变

EFFECTS OF ARTERIOVENOUS REVERSAL ON THE MORPHOLOGICAL ANDMICROCIRCULATION CHANGES OF ISCHEMIC HINDLIMB IN RABBITS

目的研究静脉动脉化对兔后肢缺血形态学及微循环的影响。方法制备兔单侧后肢缺血动物模型 ,在此基础上即刻行股浅动脉近侧端与伴行股浅静脉的端侧吻合 ,完成缺血 动静脉转流模型。于实验的第 1周、第4周时 ,分别取缺血组、缺血 动静脉转流组术肢远端的腓肠肌及胫神经组织作光、电镜观察 ,并于术前、术后 4周采集转流组的股动脉、股深静脉血做血气分析。结果缺血组术肢可见跛行 ,肢体坏死 ,动物 1周后死亡。光、电镜观察显示 :转流组术后 1周肌肉、神经组织变性坏死 ;术后 4周肌肉、神经组织出现修复性改变。血气分析显示 :术前灌注动脉血和回流静脉血与术后 4周血液比较无显著性差异 (P >0 .0 5 )。结论分期静脉动脉化可使缺血肢体的组织营养。

ObjectiveTo evaluate the effects of arteriovenous reversal on the morphological and microcirculation changes of ischemic hindlimb in rabbits. MethodsThe hindlimb ischemic models were established in rabbits. End to side anastomoses from superficial femoral artery to superficial femoral vein was performed immediately after ischemic model establishment to construct arteriovenous reversal. Morphological changes of distal calf muscle and tibial nerve were observed at light and electron microscopic levels one and four weeks respectively after arteriovenous reversal. Femoral artery and deep femoral vein blood PaO 2 and PaCO 2 before and 4 weeks after the reversal operation was comparatively analyzed in reversal group.ResultsClaudication and necrosis of the ischemic limbs were found in ischemic group and all animals in this group died one week after ischemic model establishment. Under light and electron microscope, degenerative and necrotic changes in distal calf muscle and tibial nerve could be found one week after the reversal while repairing changes appeared four weeks after the reversal. No significant changes were found in femoral artery and deep femoral vein blood PaO 2 and PaCO 2 before and 4 weeks after the reversal operation.ConclusionArteriovenous reversal could effectively improve blood supply and decrease muscle and nerve injury of the ischemic limbs.