腹主动脉瘤腔内治疗的实验研究  

Experimental study on the endoluminal treatment of the abdominal aortic aneurysm

作　　者：舒畅[1] 汪忠镐[2] 吕新生[1] 陈学明[2] 

机构地区：[1]湖南医科大学附属湘雅医院普外科,湖南长沙410008 [2]邮电总医院血管外科研究所,北京100032

出　　处：《中国普通外科杂志》2000年第2期135-138,共4页China Journal of General Surgery

摘　　要：目的　探讨腹主动脉瘤的腔内血管外科治疗方法。方法　将健康杂种犬 9只通过剖腹手术建立 4个肾动脉平面以下的腹主动脉瘤模型 (Ⅰ组 ) ,5个肾动脉平面以上的腹主动脉瘤模型 (Ⅱ组 ) ,然后经髂动脉给Ⅰ组置入支架型人工血管隔绝其腹主动脉瘤 ,对Ⅱ组则先重建双侧肾动脉和肠系膜上动脉的血流 ,然后再自髂动脉置入支架型人工血管 ,隔绝瘤体。术后观察血管通畅情况及动物存活情况 ,2 ,3个月后处死动物 ,检查支架型人工血管通畅及血管内皮生长情况。结果　腹主动脉瘤成模率为 10 0 % ,术后Ⅰ组 4只犬成活良好 ;Ⅱ组中 1只成活良好 ,另 4只分别于术后 4h ,1d ,3d ,4d后死亡。 2 ,3个月后处死动物 ,解剖发现支架型人工血管通畅 ,主动脉瘤体萎缩 ,光镜和电镜检查显示支架内及支架两端血管内皮生长良好。结论　腔内血管外科技术能有效地治疗主动脉瘤 ,特别是为肾动脉平面以上的主动脉瘤的治疗提供了一种新的方法。Objective To explore the treatment of abdominal aortic aneurysm(AAA) by endoulminal vascular technique. Methods Nine canine AAA were created, 4 aneurysms were below renal artery(Group Ⅰ), 5 were above renal arteries(Group Ⅱ). Stenting graft was deployed to isolate aneurysms through iliac artery for every dog in group Ⅰ. In group Ⅱ, the blood flow of the superior mesenteric artery and the renal arteries were reconstructed through bypass at first, then the stenting graft was deployed to isolate the aneurysms through iliac artery. After the deployment, the dimensions and the continuity of the aortic prostheses were inspectied; 2 or 3 months later, the stenting grafts were evaluated histologically by removing the AAA of the canines.Results The AAA models were gained successfully in 9 canines; 4 canines in group Ⅰ and one in group Ⅱ were alive, the 4 others in group Ⅱ were died respectively in 4 hours, 1 day, 3 days, 4 days postoperatively. The endoluminal stenting grafts were evaluated histologically by removing the AAA of the canines 2 or 3 month later postoperatively, the optical and electron microscopy showed that the endothelial layer covered the interface of the stenting graft and the two ends of the devices. Conclusions The endolumi nal vascular technique reveals more effective treatment for the AAA, especially could offer an alternative method for the AAA above renal arteries.

关 键 词：主动脉瘤/外科学 人工血管 支架 主动脉 腹 疾病模型 动物 

分 类 号：R543.160.5[医药卫生—心血管疾病] R654.2[医药卫生—内科学]