CAJ | 학술논문

目的采用3种不同的方法建立兔颈总动脉旁路移植的动物模型,比较建立各种动物模型的手术结果.方法将36例兔分为:P1组、P2组、C组,三组分别采用不同的方法建立兔颈总动脉旁路移植模型.P1组:将2~3 cm长的颈外静脉远近端倒转后端侧吻合移植至同侧颈总动脉上,结扎两吻合口间的颈总动脉.P2组:与P1组不同的是动脉离断后与倒置的静脉行端端连续吻合.C组:将同样长度的颈内静脉倒置后应用cuff管技术移植于颈总动脉.比较三组血管吻合技术的手术时间、吻合口术后即刻及4周时的通畅率,4周后静脉桥血管内,中膜增生情况.结果三种实验动物均无死亡.P1、2组动物手术时间相当,但较C组手术时间长(P<0.05).三组手术中出血量相当(P>0.05).Cuff技术制作的动静脉吻合口,大小相对固定,不容易形成手术技术的吻合口狭窄;缝合法,技术要求较高,缝合不当、打结过紧可直接导致吻合口狭窄,以端端吻合的狭窄率最高.4周后缝合法比cuff技术的吻合口管壁增生更加明显,吻合口发生狭窄的比率升高,cuff技术与端端吻合差异明显(P<0.05).静脉桥血管体部的内膜及中膜增生程度相似,无统计学差异(P>0.05).结论 Cuff技术制作兔颈总动旁路移植模型容易掌握,吻合口不易狭窄,适用于研究静脉桥血管体的病例生理变化.而缝合法手术要求高,吻合口狭窄的发生率高,但更近于临床,对研究吻合口狭窄具有重要意义.
목적 채용3충불동적방법건립토경총동맥방로이식적동물모형,비교건립각충동물모형적수술결과.방법 장36례토분위:P1조、P2조、C조,삼조분별채용불동적방법건립토경총동맥방로이식모형.P1조:장2~3 cm장적경외정맥원근단도전후단측문합이식지동측경총동맥상,결찰량문합구간적경총동맥.P2조:여P1조불동적시동맥리단후여도치적정맥행단단련속문합.C조:장동양장도적경내정맥도치후응용cuff관기술이식우경총동맥.비교삼조혈관문합기술적수술시간、문합구술후즉각급4주시적통창솔,4주후정맥교혈관내,중막증생정황.결과 삼충실험동물균무사망.P1、2조동물수술시간상당,단교C조수술시간장(P<0.05).삼조수술중출혈량상당(P>0.05).Cuff기술제작적동정맥문합구,대소상대고정,불용역형성수술기술적문합구협착;봉합법,기술요구교고,봉합불당、타결과긴가직접도치문합구협착,이단단문합적협착솔최고.4주후봉합법비cuff기술적문합구관벽증생경가명현,문합구발생협착적비솔승고,cuff기술여단단문합차이명현(P<0.05).정맥교혈관체부적내막급중막증생정도상사,무통계학차이(P>0.05).결론 Cuff기술제작토경총동방로이식모형용역장악,문합구불역협착,괄용우연구정맥교혈관체적병례생리변화.이봉합법수술요구고,문합구협착적발생솔고,단경근우림상,대연구문합구협착구유중요의의.
Objective To construct the animal model of common carotid artery bypass by three different methods and the experimental results are compared. Methods 36 rabbits were divided into three groups. P1 group:the external jugular vein was inversion and interposed to the ipsilateral common carotid artery using an end-to-side continuous suture technique;P2 group:the common carotid artery bypass was constructed by end-to-end continuous suture technique;C group:the animal model was constructed by cuff technique. The time of surgery and anastomoses,blood loss in operation,the patency of anastomoses,and the proliferation of graft vein were observed and compared between groups. Results No death was found in the three groups. The surgery time was similar between group P1 and P2,but longer than that in group C (P<0.05). Blood loss in operation was similar in three groups (P>0.05). The size of anastomoses constructed by cuff technique was relative fixed,and the stenosis of anastomoses happened infrequently. The suture method needs more techniques,improper suture and tight knots can cause the stenosis of anastomoses directly. The proliferation of vein at anastomoses was more frequent in group P1 and P2 and the rate of anastomotic stenosis was higher,more frequently happened in group P2,compared with cuff group (P<0.05). The proliferation of vein graft body parts were similar in three groups (P>0.05). Conclusion Animal model of common carotid artery bypass by cuff technique was much easier to grasp,and stenosis of anastomoses happens infrequently,which is suitable for the study of pathophysiological change on vein graft. Suture method needs more techniques,and stenosis of anastomoses happens frequently,however,it is important for the study of the anastomotic stenosis.