犬股动脉磁吻合技术与传统吻合技术的比较研究  

A COMPARATIVE STUDY ON MAGNETIC COMPRESSIVE ANASTOMOSIS AND TRADITIONAL HANDSUTURING TECHNOLOGY IN CANINE FEMORAL ARTERY ANASTOMOSIS

作　　者：刘仕琪[1,2] 雷鹏[3] 吕毅[1] 关正[4] 高睿[5] 姚维杰[1] 党国辛 刘艳奎[1] 

机构地区：[1]西安交通大学医学院第一附属医院肝胆外科,西安710061 [2]西北妇女儿童医院基础外科 [3]宁夏医科大学第一附属医院肝胆外科 [4]西安交通大学医学院第一附属医院麻醉科,西安710061 [5]西安交通大学医学院护理系

出　　处：《中国修复重建外科杂志》2014年第7期885-890,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金重点项目(30830099)~~

摘　　要：目的通过磁性压榨式吻合技术（magnetic compressive anastomosis,MCA）实现动脉血管无缝线吻合的组织学与扫描电镜观察,比较磁性血管吻合环（以下简称磁环）较传统手工缝合方法的优越性。方法 8-12月龄健康杂交犬12只,体重（16.5±3.6）kg,每只犬左、右侧股动脉分别采用MCA（A组）与传统手工缝合方法（B组）行股动脉端端吻合。比较两组吻合手术时间、并发症、吻合口耐压强度;术后2、4、12、24周分别取3只动物大体观察吻合口愈合情况,吻合口标本行HE、Masson染色及扫描电镜观察。结果 A组股动脉吻合时间（3.89±1.16）min,明显少于B组的（14.16±3.72）min（t=14.226,P=0.000）;A组吻合口并发症发生率（0）明显低于B组（75%）（P=0.000）;A组术后即刻、4周及12周吻合口耐压强度均〉280 mm Hg（1 mm Hg=0.133 kPa）,B组分别为（140.11±15.23）、（180.31±24.55）和〉280 mm Hg,术后即刻及4周时A组均高于B组（P〈0.05）,术后12周两组比较差异无统计学意义（P〉0.05）。大体、扫描电镜及组织学观察示,A组术后4周吻合口血管壁对位整齐光滑,血管腔内无异物残留,血管内膜覆盖吻合口,内皮细胞排列整齐,形态规则;12周吻合口呈慢性炎性反应,少量淋巴细胞浸润;24周无明显炎性反应。术后B组股动脉吻合口有明显缝线异物残留与瘢痕形成,血管腔内凹凸不平,内膜不完整,吻合口内皮细胞排列紊乱,形态不规则。结论MCA较传统手工缝合动脉血管耗时少、并发症少、吻合口愈合质量更好,MCA可实现股动脉无缝线吻合且效果可靠。Objective To investigate the advantages of magnetic compressive anastomosis（MCA） for non-suture femoral artery anastomosis. Methods Twelve adult health mongrel dogs, weighing（16.5 ± 3.6） kg, were selected for in situ endto-end anastomosis of the femoral artery. One side of the femoral artery was anastomosised with MCA（group A） and the other side of the femoral artery was anastomosised by hand-suturing（group B）. The anastomosis time, complications, and vascular bursting pressure were recorded. Gross observation, histological staining（HE and Masson）, and scanning electron microscopy observation were performed at 2, 4, 12, and 24 weeks postoperatively. Results The anastomosis time in group A [（3.89 ± 1.16） minutes] was signii cantly shorter than that in group B [（14.16 ± 3.72） minutes]（t=14.226, P=0.000）. The complication rate of group A（0） was signii cantly lower than that of group B（75%）（P=0.000）. At immediate, 4 and 12 weeks after operation, the vascular bursting pressure of anastomosis site in group A was more than 280 mm Hg（1 mm Hg=0.133 kPa）, and was（140.11 ± 15.23）,（180.31 ± 24.55）, and more than 280 mm Hg in group B, showing signii cant dif erences at immediate and 4 weeks（P 0.05）, but no signii cant dif erence at 12 weeks（P 0.05）. In group A at 4 weeks, good intima contact, smooth endothelium, and regular arrangement of endothelial cells were observed; at 12 weeks, chronic inl ammation was present, with a few lymphocytes ini ltration; and at 24 weeks, inl ammation signii cantly decreased. But in group B, obvious suture foreign body and scar formation were observed, which led to uneven surface with lumen incomplete intima, and irregular endothelial cells in arrangement disorder. Conclusion Compared with traditional hand-suturing, the MCA has the advantages of shorter operation time, higher patency rate, less complication, and better healing at the anastomotic site. Non-suture anastomosis of the femoral artery by MCA can achieve reliable res

关 键 词：股动脉 磁性压榨式吻合技术 血管吻合 犬 

分 类 号：R654.3[医药卫生—外科学]