改良cuff法和间断缝合法在静脉桥狭窄模型中的应用  

Applied study of improved cuff technique and intermittent suture method in vein graft stenosis model

作　　者：赵智伟[1] 葛建军[1] 周正春[1] 刘永志[1] 邬松[1] 周经月[1] 

机构地区：[1]安徽医科大学第一附属医院心脏外科,合肥230022

出　　处：《安徽医科大学学报》2010年第4期474-476,共3页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅重点项目(编号:07020303071)

摘　　要：目的比较改良cuff法和间断缝合法在建立冠状动脉旁路术后静脉桥狭窄模型中的异同。方法 40只SD大鼠随机分为cuff组和缝合组,每组20只。分别采用改良cuff法和间断缝合法,建立大鼠颈外静脉移植到同侧颈总动脉模型。结果两组均无动物死亡。cuff组动脉阻断时间及手术时间较缝合组缩短。4周后比较,cuff组与缝合组静脉桥通畅率分别为95%与85%。大体观察及病理示桥血管壁不同程度增厚,两组移植静脉中段内膜、中膜增生,但无明显差异。免疫组化示增殖细胞核抗原(PCNA)表达增强。结论两者均能真实反映冠状动脉旁路术后静脉桥狭窄的情况。改良cuff法较间断缝合法更加简单,出血量少,是建立静脉桥狭窄模型更为理想的方法 。Objective To compare the improved cuff technique and the intermittent suture method in establishing vein graft stenosis model after coronary artery bypass graft.Methods 40 SD rats were randomly divided into the cuff group and the suture group,20 rats in each group. Established the external jugular vein graft to the ipsilateral common carotid artery model using cuff technique and the intermittent suture method in rats respectively.Results There were no animal death in two groups.Cuff group artery clamp time and operation time were shorter than the suture group.4 weeks after transplantation,cuff group and the suture group vein graft patency rates were 95% and 85% respectively. Histopathology showed different levels of vascular wall thickening,two groups of middle vein graft intimal and medial hyperplasia,but there were no significant difference.Immunohistochemistry showed proliferating cell nuclear antigen（PCNA）increasing.Conclusion Cuff technigue and inter mittent suture both can truly reflect the situation of vein graft stenosis after coronary artery bypass surgery.Improved cuff technique,less blood lossing,is simpler and more desirable than the intermittent suture method.

关 键 词：冠状动脉旁路移植术 非体外循环 冠状动脉再狭窄 血管内膜 

分 类 号：R654.2[医药卫生—外科学] R543.3[医药卫生—临床医学]