PTFE血管加自体静脉段减轻动脉内膜增生的实验研究  

An Experimental Study on PTFE Graft Plus Autogenous Vein Cuff in Alleviating Arterial Intimal Hyperplasia.

作　　者：景在平[1] 曲乐丰[1] 曹贵松[1] 仲剑平[1] 

机构地区：[1]中国人民解放军第二军医大学附属长海医院血管外科,200433

出　　处：《外科理论与实践》1999年第4期221-223,共3页Journal of Surgery Concepts & Practice

基　　金：国家自然科学基金资助(No.39670707)

摘　　要：目的:探讨PTFE人造血管加自体静脉段吻合对动脉内膜增生的缓和作用。方法:12只健康杂种犬的24条犬腿随机分成对照组及实验组。对照组股动脉阻断后,以PTFE人造血管直接行旁路转流术,实验组以自体颈外静脉段间置于PTFE与远端股动脉之间,术后第八周动脉造影后,收集标本行病理组织学观察及计算机图象分析测算增生内膜、中膜的厚度,增生内膜的截面面积、血管腔截面面积及两者的比值和静脉“动脉化”后中膜的厚度,同时,行间置静脉扫描电镜观察。结果:血管造影示两组通畅率分别为16.7％和66.7％(P<0.05);内膜厚度分别是483.5μm±67.3μm和147.1μm±38.6μm(P<0.1);中膜厚度组间差异不明显;增生内膜面积分别是5217±1123(pixel)和3117±890(pixel),分别占血管腔截面的80.9％±17.2％和47.7±13.7％(P<0.01);间置静脉呈动脉化表现。结论:间置自体静脉段能明显减轻PTFE管旁路手术后的动脉内膜增生,有效地提高血管手术后的通畅率。Objective: To explore the alleviation of arterial intimal hyperplasia resulting from the insertion of an auto-genous vein cuff between the PTFB prosthesis and the artery. Methods: Twenty-four hindlimbs of 12 mongrel dogs were randomly divided into control and study groups. PTFE bypass was made only in the control group, whi-le an autologous vein cuff was added distal to the prosthesis in the study group. Eight weeks after operation, angiography was made and specimens were harvested and subjected to histomorphological studies and image analysis by computer scanning electromicroscopy was also carried out on the vein cuff. Results: Angiography demonstrated that the rate of patency in the control and study groups was 16.7% and 66.7% respectively; the thickness of intima: 483.5μm±67.3μm and 147.4μm±38.6μm respectively; no obvious change occurred in the me-dia; the surface area of intimal hyperplasia was 5217±1123(pixel) and3117±890(pixel) respectively, accounting to 80.9%±17.2% and 47.7%±13.7% of the sectional area of the vascular lumen. Arterialization was noted in the interposed vein cuff. Conclusions: The interposition of an autologous vein cuff obviously mitigated arterial in-timal hyperplasia after PTFE bypass procedure, thus improving the postoperative patency of the vessels.

关 键 词：内膜增生 旁路转流术 自体移植 PTFE 静脉移植 

分 类 号：R654.4[医药卫生—外科学]