结扎小肠一侧系膜肠壁血管对其血运影响的实验研究  

Bowel Viability After Ligation of Straight Arcade Arteries on One Side of Mesentery

作　　者：李龙[1] 张金哲[1] 陈晋杰[1] 张连柱[1] 董瑞安[1] 

机构地区：[1]首都医科大学附属北京儿童医院外科

出　　处：《中华小儿外科杂志》1999年第1期35-37,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的了解结扎切断小肠一侧系膜肠壁血管对整个肠壁的影响。方法实验对象为新西兰大白兔２５只、随机分为对照组５只、急性实验组１０只和慢性组１０只。对急性实验组动物，结扎切断１５ｃｍ范围的末段回肠的一侧系膜肠壁血管，观察肠壁的血运变化；慢性实验组动物，相同方法结扎一侧系膜血管，然后饲养一个，再行剖腹手术观察肠管情况。实验之肠管均行血管构筑，扫描电镜观察。结果对照组中可见小肠系膜的Ⅲ级血管弓向两侧肠壁发出系膜肠壁血管，其主干在两侧肠壁的中１／３段内穿入肌层，在粘膜下层呈树枝状分枝，与相邻和对侧的系膜肠壁血管分枝相吻合形成粘膜下血管网，遍布整个粘膜下层。由此血管网向粘膜层和肌层分别发出分枝形成粘膜毛细血管丛和肌层毛细血管丛。断离一侧系膜肠壁血管后３０分钟和１个月后，肠壁的血运无障碍，肠管蠕动良好，无狭窄及造成肠梗阻者。电镜下见肠壁的粘膜下血管网及粘膜和肌层血管丛完整。结论结扎小肠一侧系膜肠壁血管不影响整个肠壁的血运，结扎侧的肠壁靠其粘膜下的血管网供血，因此可以认为小肠壁受两侧系膜肠壁血管的双重供血。Objective The aim of the study was to assess the viability of bowel after ligation of straight arcade artery on one side of mesentery.Methods Twenty five New Zealand white rabbits were randomised into three groups, namely, control group (n=5), acute group (n=10) and chronic group (n=10). The straight arcade arteries on one side of mesentery of terminal 15 cm of ileum were ligated. The latter two groups were sacrificed 30 minutes and 1 month after the ligation. Specimens from the three groups were examined for microcirculation and ultra structural changes under scanning electromicroscopy.Results The straight arteries of arcade penetrated the intestinal muscular layer 1/3 of way along the side wall and then arborised under the mucosal layer, forming anastomosis with the neighbouring vessels. In acute and chronic groups. microcirculation and peristalsis were normal. Electro microscopic examination also revealed normal submucosal and intra muscular microcirculation.Conclusions Ligation of straight arcade arteries on one side of small bowel mesentery dose not affect the microcirculation, suggessting dual blood supply of intestine from both sides of mesentery. The finding provides anatomical evidence for resection of bowel in intestinal duplication.

关 键 词：小肠 血液循环 血管 小肠系膜血管 结扎 

分 类 号：R656[医药卫生—外科学] R331[医药卫生—临床医学]