兔颈动脉无缝线胶黏吻合与传统缝线吻合的对比研究  

Comparative study on sutureless adhesive anastomosis and conventional suturing anastomosis of carotid artery in rabbits

作　　者：曲乐丰[1] 王玉琦[2] 景在平[1] 

机构地区：[1]第二军医大学附属长海医院血管外科,上海200433 [2]复旦大学附属中山医院血管外科

出　　处：《中华实验外科杂志》2004年第4期411-413,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目 (30 1 70 92 6)

摘　　要：目的　对比研究兔颈动脉无缝线胶黏吻合与传统缝线吻合的手术操作情况和吻合口通畅情况。方法　将 16只新西兰大白兔随机分为对照组和实验组 ,记录每个吻合口的吻合时间及出血量 ,术后 1、2、4、12周分别取材观察其通畅情况 ,并对吻合口内膜增生情况行病理切片和计算机图像分析。结果　与对照组相比 ,实验组的手术时间明显缩短 [(8.19± 6.5 1)min比 (2 0 .5 0± 14 .3 5 )min] ,术中出血量明显减少 [(2 .44± 5 .83 )ml比 (10 .3 8± 17.49)ml] ,通畅率也较高 (93 .8%比87.5 % ) ,内膜增生程度明显减轻 ,术后 1、2、4、12周时其内膜厚度分别降低了 3 1.4%、2 4.5 %、2 3 .9%和 3 1.9% (P <0 .0 1) ,其内膜面积分别降低了 3 6.2 %、2 9.1%、3 1.3 %和 40 .0 % (P <0 .0 1)。结论　中小血管的无缝线胶黏吻合较传统的缝线吻合操作省时省力 ,术中出血少 ,避免了缝针和缝线对血管吻合口处的透壁性损伤 ,消除了缝线等异物对管壁的持续性刺激所致的增生性反应 ,使吻合口处内膜增生减轻 ,吻合口通畅率提高。ObjectiveTo make a comparative study on intra-operative manipulation and post-operative patency between sutureless adhesive anastomosis and conventional suturing anastomosis in rabbit common carotid artery.MethodsSixteen Newzealand white rabbits were randomly and equally divided into two groups:control group and experimental group.The anastomosing time and intra-operative blood loss were recorded and post-operative patency rate and intimal hyperplasia degree were analyzed and calculated.ResultsIn the experimental group,the anastomosing time was greatly shortened [(8.19± 6.51) min vs (20.50±14.23) min],the blood loss was significantly decreased [(2.44±5.83) ml vs (10.38±17.49) ml],the patency rate was obviously increased (93.8% vs 87.5%) as compared with control group.The imaging analysis of pathological slices demonstrated a minor degree of intimal hyperplasia in experimental group and the intimal thickness decreased by 31.4%,24.5%,23.9% and 31.9% ( P <0.01) compared with the traditional suturing group at postoperative week 1,2,4 and 12,respectively.So was the intimal areas with 36.2%,29.1%,31.3% and 40.0% respectively ( P <0.01).ConclusionThe sutureless adhesive anastomosis is easily handled and time-saving and the intra-operative blood loss is decreased.This method avoided the transmural injury by the needle and suture and thus eliminated the proliferative reaction by the foreign bodies such as suture,then the intimal hyperplasia degree decreased and patency rate increased.

关 键 词：兔 颈动脉 无缝线胶黏吻合 对比研究 医用胶 吻合口狭窄 血管 传统缝线吻合 

分 类 号：R654.3[医药卫生—外科学]