微动脉和微静脉移植愈合过程的实验研究。口腔再造术临床应用的可能性[j]。

Ou Daigaku shigakushi Pub Date : 1990-07-01
I Mita
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引用次数: 0

摘要

选用Wistar雌性大鼠63只,体重250 ~ 350g,观察右股动脉和右股静脉自体动-动脉和静脉移植术的通畅率和组织学变化。以左股动脉和左股静脉为对照。术后4天、7天、14天、28天和56天取出移植物。采用Hayhurst和O'Brien的方法检查通畅率。采用光镜和扫描电镜观察移植物的组织学变化。动脉-动脉移植在整个实验过程中保持了较高的通畅率(90.0%,27/30)。这种高通畅率可能是由于吻合后立即进行血运重建所致。静脉-静脉移植平均通畅率为75.8%(25/33)。静脉-静脉移植物第14天和第28天的通畅率均为100%,这可能与移植物内层内皮细胞较早完成有关。移植后保存的内皮细胞及动脉、静脉内皮细胞均可再生。动脉移植血管中保存的内皮细胞数量少于静脉移植血管。因此,动脉移植血管内皮细胞完成覆盖的速度要慢于静脉移植血管。动脉-动脉移植的阻塞是由缝合过程中血管破裂形成的血栓引起的。在静脉-静脉移植中,暴露的血管壁上的血栓导致阻塞。所有动脉移植物均可见内膜下增生。静脉移植未见上述变化。这些结果表明吻合后立即进行血运重建,严密和无损伤的缝合操作对于预防动-动脉移植和静脉-静脉移植的梗阻是重要的。
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[An experimental study on healing processes of microarterial and microvenous transplantation. The possibility of clinical application in oral reconstructive surgery].

Sixty-three Wistar female rats, weighing from 250 to 350g were used in order to investigate patency rate and histological changes of arterio-arterial and veno-venous autografts, using the right femoral artery and vein. The left femoral artery and vein served as control. The grafts were retrieved over a period of time ranging from 4, 7, 14, 28 and 56th day postoperatively. The patency rate was checked by Hayhurst and O'Brien's method. The histological changes of grafts were evaluated by the light and scanning electron microscope. Arterio-arterial graft maintained high patency rate throughout the experiment (90.0%, 27/30). This high patency rate may be explained by revascularization immediately after anastomosis. The average patency rate in veno-venous graft was 75.8% (25/33). Patency rate in 14th and 28th day in veno-venous graft showed 100%, that seemed to be related to the early completion of endothelial cells lining of the graft. Regeneration proceeded from the preserved endothelial cells in graft as well as endothelial cells of the artery and vein. The number of preserved endothelial cells in the arterial graft was fewer than that in the venous one. Therefore, the completion of covering by endothelial cells in arterial graft was slower than that in venous graft. The obstruction in arterio-arterial graft was caused by thrombus in the rupture of vessels formed by the suture procedures. In veno-venous graft, thrombus on the exposed vessels' wall resulted in the obstruction. Subintimal hyperplasia was seen in all arterial graft. No such change was seen in venous graft. These results indicate that revascularization immediately after anastomosis, tight and atraumatic suture procedures are important for the prevention of obstruction in arterio-arterial graft and veno-venous graft.

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