不同牵拉力对大隐静脉血管壁损伤的程度分析研究  

Analysis the damage of different stretch force on the great saphenous vein wall

作　　者：高峰[1] 庄熙晶[1] 高洋[1] 石磊[1] 何学志[1] GAO Feng;ZHUANG Xijing;GAO Yang;SHI Lei;HE Xuezhi(Major caradial vascular surgery in central Hospital of Dalian city, Dalian ! 16000, China)

机构地区：[1]辽宁大连市中心医院心脏大血管外科,辽宁大连116000

出　　处：《宁夏医学杂志》2018年第4期304-306,共3页Ningxia Medical Journal

摘　　要：目的对比分析不同牵拉力对冠状动脉旁路移植术(CABG)中大隐静脉血管壁损伤程度的影响,探讨大隐静脉采集过程中的安全牵拉力,提高手术过程中对大隐静脉采集血管的保护意识,提高临床中冠脉旁路移植术静脉桥血管的远期通畅率。方法筛选40例行CABG的患者,取其CABG术中大隐静脉(GSV),将其平分成5段,分别为无牵拉组(对照组)、5 g砝码垂直牵拉1 min组(实验组A)、10 g牵拉1 min组(实验组B)、10 g牵拉2min组(实验组C)、20 g牵拉1 min组(实验组D)。标本行HE染色,用光镜观察血管壁细胞形态、结构、肌纤维板等结构的改变。结果对照组与各实验组之间血管壁细胞形态、结构、肌纤维板等镜下结构差异有统计学意义(P<0.05),实验组A与D组、实验组B与D组、实验组B与C组之间比较差异有统计学意义(P<0.05)。结论大隐静脉易因外科牵拉而损伤,同样的牵拉力持续作用于血管的拉力时间越长,对血管的负面影响就越大。Objective To compare and analysis the damage of different tension of saphenous vein wall in coronary artery bypass grafting （CABG） in order to investigate the safety pull force during the harvesting of great saphenous vein and advance the protection during surgery, and to improve the long - term patency rate of vein grafts after coronary artery bypass grafting. Methods 40 patients ae- cepted coronary artery bypass grafting. The remaining great saphenous vein （GSV） was taken and the venous specimens were divided in- to 5 segments averagely,arranged in 5 groups： no pull specimens （control group） ,5g weight vertical pull for 1 minutes （group 1 ）. 10g stretch for 1 minutes （group 2） ,10g stretch for 2 minutes （group 3） ,20g stretch for 1 minutes （group 4）. After HE staining,light mi- croscopy was used to observe the morphology and structure of vascular wall cells, muscle fiber board microscopic structure change. The vascular wall of the sample was graded according to pathological changes. Results There is no significant difference （ P 〉 O. 05 ） be- tween the experimental group 1 and the control group on pathological grading Ⅰ, Ⅱ level. The experimental group 2 have more Ⅲ degree than the group 1, but there is no significant difference （ P 〉 0.05 ） between the two groups. The vascular wall injury of the 4 groups was significantly higher than that of the 2 groups with statistical significance （P 〈 0.05）. 3 samples of vascular disease grading showed that 2 group was better than the 3 groups ,which had statistical significance （ P 〈 0.05 ）. Conclusion The stretch force produced the damage of the great saphenous vein. The longer the duration of the same stretch force acting on the vessel, the more obvious the damage to the vein wall.

关 键 词：冠状动脉旁路移植术 大隐静脉采集 牵张力 血管壁 

分 类 号：R622.4[医药卫生—整形外科]