国产全热解碳双叶型人造瓣膜抗血栓动物实验观察  

Observation of the Antithrombotic Property of A New Prosthetic Heart Valve in Sheep

作　　者：徐世伟[1] 陈芳[1] 陈如坤[1] 董爱强[1] 

机构地区：[1]浙江大学医学院附属第二医院心胸外科,杭州310009

出　　处：《生物医学工程学杂志》2002年第4期596-598,共3页Journal of Biomedical Engineering

摘　　要：为了较好地了解国产全热解碳双叶型人造瓣膜的抗血栓性能。对 15只绵羊在体外循环直视下作了该人造瓣膜的置换术 ,术后 2 4h开始用肝素抗凝 3个月 ,对手术早期死亡的羊和长期存活 ,后经处死的羊作尸体解剖 ,以观察该人造瓣膜是否引起血栓栓塞。结果在 15只羊中有 10只在手术后 48h内死亡 ,5只长期存活 ,以后分别处死 ,2只在术后 1周、1只在 12周、2只在 2年 6个月。尸解表明 ,早期死亡的羊 ,其人造瓣膜机械性能均良好 ,人造瓣膜周围及各重要脏器未见有血栓栓塞现象。 5只长期存活处死的羊 ,1周时 ,见人造瓣膜的缝环上已形成一薄层微血栓 ;12周 ,缝环已被自体组织层覆盖 ,微血栓已基本机化和内皮细胞化 ;2年 6个月 ,缝环组织层已完全机化和内皮细胞化 ,组织层厚度约 1～ 1.2 m m。所有羊的重要脏器内未见血栓栓塞现象。本实验表明 ,国产全热解碳双叶型人造瓣膜具有较好的耐磨性。To observe the antithrambotic property of a prosthetic made double bileaflet valve of all-pyrolytic carbon. Method: fifteen sheep underwent mitral valve replacement (MVR) with this mechanical valve. Each animal was placed on cardiopulmonary bypass. All of the sheep were given in an anticoagulation protocol and followed for three months. Final studies were performed on all animals surviving for more than 12 weeks. Result: ten sheep died within 48 h after operation, five sheep survived. The long-term survivors were killed forautopsies, two sheep were killed in the 1st week after operation, one in 12th weeks and two in 2.5 years. Pathological examination of 10 sheep which died early after operation revealed that there was no either evidence of thromboembotic phenomenon, or any failures of the mechanical valve. Autopsy studies in the five long-term survivors revealed that the sewing ring was covered by a thin layer of microthrombi consisted most of platelets and fibrin in 1st week after operation. The sewing rings was covered by a tissue layer, with partial organized micro thrombi and endothelialization in 12th weeks after the operation. Two and half years after operation, the complete endothelialization presented around the sewing ring without restriction of bileaflet motion. The tissue ingrowth tends to stop at the pyrolytic carbon-fabric interface on both surfaces of left atrium and ventricle. This study demonstrated that the prosthetic heart valve had not promoted thrombosis and thrombembolism.

关 键 词：全热解碳双叶型人造瓣膜 体外循环 热解碳 人造瓣膜 瓣膜置换 抗血栓性能 

分 类 号：R318.1[医药卫生—生物医学工程]