中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2007年
31期
6318-6320
,共3页
颉强%杨柳%赵黎%黄耀添%胡蕴玉%李珏
頡彊%楊柳%趙黎%黃耀添%鬍蘊玉%李玨
힐강%양류%조려%황요첨%호온옥%리각
血管%应力%应变%残余应变
血管%應力%應變%殘餘應變
혈관%응력%응변%잔여응변
背景:由于种属间的差异,只有人体血管的数据,才对医学临床实际有特殊而直接的意义.目的:从人体四肢动、静脉的纵向残余应变及应力-应变关系方面探讨四肢动、静脉的血管生物力学特性对损伤修复方法选择的影响.设计:观察性实验.单位:解放军第四军医大学西京医院骨科.材料:实验于2005-09/2006-09在解放军第四军医大学西京医院完成.标本取自13例男性急性严重头颅创伤死亡患者(已签署捐献同意书),年龄18～30岁.方法:①动、静脉血管标本的切取与保存:死亡后2 h内取材.用亚甲蓝在四肢主要动、静脉血管上做标记点,用游标卡尺测定各标记点间距,切取标记段血管并立即放入置于冰盒中的Kreb液中,随后转入冰箱中冷藏保存(0～5 ℃).②纵向伸长率的测定:将血管置于室温下装有Kreb液的培养皿中,15 min后用游标卡尺测得血管上亚甲蓝标记点间距,由实验中亚甲蓝标记点间距切取前后变化值计算获得血管纵向伸长率(实验温度20～25 ℃),取材后2 h内完成全部测试.③拉伸实验:取长1.0 cm血管试样装入仪器后进行单向拉伸实验,血管试样始终保持在Kreb液中,取材后5 h内完成全部测试(实验温度20～25 ℃).每一血管标本加载、卸载血管位移长度与对应载荷值均取3次的平均值,用实测数据拟合出应力-应变曲线.主要观察指标:四肢正常动、静脉纵向伸长率、纵向残余应变及应力-应变关系.结果:人体四肢主要动脉由近心端向远心端走行,纵向伸长率逐渐减小,静脉与之相反;四肢主要动脉与头静脉、大隐静脉纵向伸长率间大多存在明显差异(P＜0.001).四肢主要动脉由近心端向远心端走行时,应力-应变关系曲线逐渐右移,说明血管刚度值逐渐减小.而静脉则相反,曲线逐渐左移,说明血管刚度值逐渐增大.结论:人体四肢主要动脉由近心端向远心端走行,纵向残余应变逐渐减小,血管刚度值逐渐减小,静脉与之相反.提示临床修复四肢不同部位动、静脉损伤时,应考虑其相应血管的纵向生物力学特性影响,选用各自适合的修复方法.
揹景:由于種屬間的差異,隻有人體血管的數據,纔對醫學臨床實際有特殊而直接的意義.目的:從人體四肢動、靜脈的縱嚮殘餘應變及應力-應變關繫方麵探討四肢動、靜脈的血管生物力學特性對損傷脩複方法選擇的影響.設計:觀察性實驗.單位:解放軍第四軍醫大學西京醫院骨科.材料:實驗于2005-09/2006-09在解放軍第四軍醫大學西京醫院完成.標本取自13例男性急性嚴重頭顱創傷死亡患者(已籤署捐獻同意書),年齡18～30歲.方法:①動、靜脈血管標本的切取與保存:死亡後2 h內取材.用亞甲藍在四肢主要動、靜脈血管上做標記點,用遊標卡呎測定各標記點間距,切取標記段血管併立即放入置于冰盒中的Kreb液中,隨後轉入冰箱中冷藏保存(0～5 ℃).②縱嚮伸長率的測定:將血管置于室溫下裝有Kreb液的培養皿中,15 min後用遊標卡呎測得血管上亞甲藍標記點間距,由實驗中亞甲藍標記點間距切取前後變化值計算穫得血管縱嚮伸長率(實驗溫度20～25 ℃),取材後2 h內完成全部測試.③拉伸實驗:取長1.0 cm血管試樣裝入儀器後進行單嚮拉伸實驗,血管試樣始終保持在Kreb液中,取材後5 h內完成全部測試(實驗溫度20～25 ℃).每一血管標本加載、卸載血管位移長度與對應載荷值均取3次的平均值,用實測數據擬閤齣應力-應變麯線.主要觀察指標:四肢正常動、靜脈縱嚮伸長率、縱嚮殘餘應變及應力-應變關繫.結果:人體四肢主要動脈由近心耑嚮遠心耑走行,縱嚮伸長率逐漸減小,靜脈與之相反;四肢主要動脈與頭靜脈、大隱靜脈縱嚮伸長率間大多存在明顯差異(P＜0.001).四肢主要動脈由近心耑嚮遠心耑走行時,應力-應變關繫麯線逐漸右移,說明血管剛度值逐漸減小.而靜脈則相反,麯線逐漸左移,說明血管剛度值逐漸增大.結論:人體四肢主要動脈由近心耑嚮遠心耑走行,縱嚮殘餘應變逐漸減小,血管剛度值逐漸減小,靜脈與之相反.提示臨床脩複四肢不同部位動、靜脈損傷時,應攷慮其相應血管的縱嚮生物力學特性影響,選用各自適閤的脩複方法.
배경:유우충속간적차이,지유인체혈관적수거,재대의학림상실제유특수이직접적의의.목적:종인체사지동、정맥적종향잔여응변급응력-응변관계방면탐토사지동、정맥적혈관생물역학특성대손상수복방법선택적영향.설계:관찰성실험.단위:해방군제사군의대학서경의원골과.재료:실험우2005-09/2006-09재해방군제사군의대학서경의원완성.표본취자13례남성급성엄중두로창상사망환자(이첨서연헌동의서),년령18～30세.방법:①동、정맥혈관표본적절취여보존:사망후2 h내취재.용아갑람재사지주요동、정맥혈관상주표기점,용유표잡척측정각표기점간거,절취표기단혈관병립즉방입치우빙합중적Kreb액중,수후전입빙상중랭장보존(0～5 ℃).②종향신장솔적측정:장혈관치우실온하장유Kreb액적배양명중,15 min후용유표잡척측득혈관상아갑람표기점간거,유실험중아갑람표기점간거절취전후변화치계산획득혈관종향신장솔(실험온도20～25 ℃),취재후2 h내완성전부측시.③랍신실험:취장1.0 cm혈관시양장입의기후진행단향랍신실험,혈관시양시종보지재Kreb액중,취재후5 h내완성전부측시(실험온도20～25 ℃).매일혈관표본가재、사재혈관위이장도여대응재하치균취3차적평균치,용실측수거의합출응력-응변곡선.주요관찰지표:사지정상동、정맥종향신장솔、종향잔여응변급응력-응변관계.결과:인체사지주요동맥유근심단향원심단주행,종향신장솔축점감소,정맥여지상반;사지주요동맥여두정맥、대은정맥종향신장솔간대다존재명현차이(P＜0.001).사지주요동맥유근심단향원심단주행시,응력-응변관계곡선축점우이,설명혈관강도치축점감소.이정맥칙상반,곡선축점좌이,설명혈관강도치축점증대.결론:인체사지주요동맥유근심단향원심단주행,종향잔여응변축점감소,혈관강도치축점감소,정맥여지상반.제시림상수복사지불동부위동、정맥손상시,응고필기상응혈관적종향생물역학특성영향,선용각자괄합적수복방법.
BACKGROUND: Due to the difference of species, the data of vessel in human are particularly useful for the clinical practice.OBJECTIVE: To analyze the longitudinal residue strain and the relationship between stress and strain of human limb arteries and veins, and explore the influence of different biomechanical properties on the repairs of limb injury.DESIGN: Observational trials.SETTING: Institute of Orthopaedics, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: The experiment was carried out in the Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA from September 2005 to September 2006. The specimens were taken from 13 male amputee donors(who treated for accident injury), aged 18 to 30 years. Those tissue samples were used with the approval from the donors and offered by Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.METHODS: ①Harvest and preservation of samples: The samples were obtained within 2 hours after death. The vessels were calibrated and harvested without any large branch to avoid the influence on the mechanical property of vessel wall,and then token on major vessels of limbs with Methylene Blue. The distance between the points token on vessel was measured by vernier caliper. The token vessels were cut and taken into Kreb's liquid in ice casement, then were kept into freezer (0-5 ℃). ②Longitudinal stretch ratio measurement: The vessels were taken into Kreb's liquid and the distance between the points token on vessel was measured by vernier caliper. The longitudinal residue strain was expressed by longitudinal stretch ratio. Lab temperature was 20-25 ℃, experiment was finished in 2 hours after sampling.③Stretch test: The vessel cut 1.0 cm was set into the instrument with Kreb's liquid for uniaxial tension test. The change length of each vascular specimen with or without the load and each load was measured three times and was averaged, lab temperature was 20-25 ℃, and experiments were finished in 5 hours after sampling. The curve of stress-strain was fitted by the measured data.MAIN OUTCOME MEASURES: Longitudinal stretching ratio, residue strain and stress-strain relationship of normal limb arteries and veins.RESULTS: The longitudinal stretch ratio of each artery decreased along vascular branch from proximal heart part to distal heart part, and that of each vein was contrast; There were significant difference in the longitudinal stretch ratios of major artery compared with those of saphena megna vein and branchiocephalicae vein (P ＜ 0.001). The curve of artery shifting right showed the stiffness of vessels decreased along vascular branch from proximal heart part to distal heart part. That of vein shifting left showed the stiffness of vessels increased along vascular branch.CONCLUSION: With the major artery of human limbs from proximal end to distal end, both the longitudinal residue strain and the vascular stiffness gradually decreases, as for the vein, the condition is contrast. It suggests that the longitudinal biomechanical property should be involved into the consideration of repairing the artery and vein injuries of different sites.
