CAJ | 학술논문

目的研究一种能快速完成门静脉(PV)端-端吻合的磁性血管吻合器,利用磁吻合技术(MCA)达到肝移植术中PV快速吻合目的.方法西安近郊杂种犬16只按照PV吻合方式不同随机分为MCA组与手工缝合组.比较磁吻合与手工缝合技术吻合PV的效果,观察两组吻合时间、术中吻合口渗漏血情况.术后彩色多普勒超声与血管造影检查观察吻合口血流及并发症情况.结果 MCA组较手工缝合组血管吻合耗时明显缩短[(3.55±2.11) min比(13.25±2.74) min;P＜0.01].MCA组术中吻合口无渗漏血发生,手工缝合组有5例出现吻合口渗漏血并发症.血管X线造影与彩色多普勒超声检查显示MCA组吻合口血流通畅,无狭窄及血栓形成；手工缝合组术后1～4周时2例发生吻合口轻度狭窄并发症.结论 MCA是一种简单、快速、效果可靠的血管吻合技术,可减少由于传统手工缝合方法导致的吻合口并发症,改善吻合口质量,有利于手术后恢复.
목적 연구일충능쾌속완성문정맥(PV)단-단문합적자성혈관문합기,이용자문합기술(MCA)체도간이식술중PV쾌속문합목적.방법 서안근교잡충견16지안조PV문합방식불동수궤분위MCA조여수공봉합조.비교자문합여수공봉합기술문합PV적효과,관찰량조문합시간、술중문합구삼루혈정황.술후채색다보륵초성여혈관조영검사관찰문합구혈류급병발증정황.결과 MCA조교수공봉합조혈관문합모시명현축단[(3.55±2.11) min비(13.25±2.74) min;P＜0.01].MCA조술중문합구무삼루혈발생,수공봉합조유5례출현문합구삼루혈병발증.혈관X선조영여채색다보륵초성검사현시MCA조문합구혈류통창,무협착급혈전형성；수공봉합조술후1～4주시2례발생문합구경도협착병발증.결론 MCA시일충간단、쾌속、효과가고적혈관문합기술,가감소유우전통수공봉합방법도치적문합구병발증,개선문합구질량,유리우수술후회복.
Objective To evaluate the magnetic pinned-ring device for non-suture vascular anastomosis.Methods Sixteen adult mongrel dogs of either gender were randomly divided into two groups for portal vein (PV) in situ end-to-end anastomosis.The magnetic compressive anastomosis (MCA) group (n=8) used magnetic rings for PV reconstruction,and the hand-sewn group (n=8) used hand suturing for PV reconstruction.Operation time and stoma errhysis were recorded.Patency and stoma stenosis was confirmed via color Doppler ultrasound scans and X-ray cholangiography at different time points as late as 4 weeks after surgery.Results The time required to perform the vascular anastomosis was significantly shorter for the magnetic device than for hand sewing [(3.55± 2.11) min vs (13.25±2.74) min; P＜0.01].5 cases had stoma errhysis during PV hand-sewing anastomosis that had to be repaired,but no stoma errhysis occurred in the MCA group.Vascular X-ray angiography and color Doppler ultrasound found blood flow to be normal and without stoma stenosis in the magnetic anastomosis group,but there were 2 stoma stenoses in the hand sewn group.Conclusions The magnetic ring device offers a simple,fast,reliable,and efficacious technique for non-suture vascular anastomosis.Application of the MCA technique can effectively reduce the complication caused by operation technique,resulting in a smoother operation and improved prognosis.