应用腹膜进行门静脉修复重建的实验研究  

Study on the Replacement of the Portal Vein of Pig with Autogeneous Peritoneal Tube

作　　者：陈伟强[1] 区庆嘉[1] 肖明 

机构地区：[1]中山医科大学孙逸仙纪念医院,广州510120

出　　处：《中国医学科学院学报》1998年第4期246-250,共5页Acta Academiae Medicinae Sinicae

基　　金：广东省97重点科研攻关项目;孙逸仙纪念医院科研基金(9745)

摘　　要：目的 探讨自体腹膜管能否应用于门静脉重建。方法 采用健康幼猪27头,切除2.5～3cm长门静脉,分别代以自体腹膜管、自体静脉和涤纶人工血管,观察移植后腹膜管通畅率及组织病理变化。结果 在移植后的早期,腹膜管径轻度均匀扩张,管腔通畅率12/13(92.3%);在移植后3个月,管周纤维组织增生明显,通畅率为8/10(80.0%);移植后5个月,通畅率为4/6(66.7%);其通畅率较采用自体静脉修复稍低;而3例采用人工血管者均在术后3～5h内死亡,尸解发现人工血管内血栓栓塞;移植后12周扫描电镜显示腹膜管表面为内皮样细胞覆盖,透视电镜下发现含内皮细胞和间皮细胞二种成分。结论 腹膜管替代重建门脉远期通畅率较自体静脉稍低,腹膜是一种很有希望的、自体门脉修复重建材料,值得进一步深入研究。Objective To investigate the possibility of applying autogeneous peritoneal tube in the portal vein reconstruction. Methods Twenty-seven small healthy domestic pigs were used. A section of portal vein about 2.5～3.0cm long was resected and replaced by autogenous peritoneum tube (APT), autogenous vein and decron artificial blood vessel respectively. Patency and pathological changes of the APT grafts were investigaed after the replacement. Results Twenty-four animals survived the operation. In the early stage of replacement, the APTs were dilated slightly, the cannual patency rate (CPR) was 12/13(92.3%). 3 months later, the fibrous hypertrophy and thickness were observed. The CPR was 8/10(80%). 2 more months later, the CPR was 4/6(66.7%), which was quite similar to that reconstructed by autogeneous vein. All three pigs which were replaced by decron blood vessel were dead within three to five hours after operation because of portal thrombi found by autopsy. After 12 weeks of replacement, scanning electron microscopy revealed that APT grafts were covered with a layer of endothelial-like cells. Endothelial cells and mesothelial cells were seen under transmitted electronic microscopy. Conclusions The long-term patency of the APTs were slightly lower than that of the autogenous vein, peritoneum might be a perspective selfmaterial for portal vein reconstruction and worth further studying.

关 键 词：门静脉 修复 重建术 腹膜移植 

分 类 号：R654.305[医药卫生—外科学]