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[动脉人工血管吻合口强度的实验研究:吻合口抗张强度与其组织结构的关系]

[An experimental study of the strength in arterial prosthetic anastomoses: relationship between anastomotic tensile strength and its organization].

作者信息

Ashizawa K

机构信息

First Department of Surgery, Yokohama City University School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1991 Jul;92(7):874-84.

PMID:1832205
Abstract

Five types of 6-mm diameter arterial prostheses, i.e.m woven Teflon, woven Dacron, velour woven Dacron, velour knitted Dacron and expanded polytetrafluoroethylene (E-PTFE), were studied in the dog to assess anastomotic tensile strength and its organization. Five types of composite grafts, about 3.0cm in length, were implanted in the abdominal aorta of fifty-two adult mongrel dogs using absorbable polyglycolic acid suture. At 16 weeks after the implantation, if the composite graft was patent, tensile strength of the bilateral anastomoses were measured and its organizations were examined microscopically. The mean forces required to disrupt the anastomoses of velour woven Dacron, velour knitted Dacron and E-PTFE were greater than those of woven Teflon and woven Dacron. At the disrupted sites of woven Teflon and woven Dacron, which were non-velour grafts, fibrous outer sheath were remarkably separated from the grafts. This results indicate that organization and fixation of fibrous outer sheath are the most important factors in the strength of arterial prosthetic anastomoses and velour grafts have superiority over non-velour grafts. The organization of E-PTFE was poor, but its tensile strength was equal to velour grafts. It is considered E-PTFE has an advantage due to non-crimped structure and requires further evaluation over longer period.

摘要

对五种直径6毫米的动脉假体进行了研究,即编织聚四氟乙烯、编织涤纶、丝绒编织涤纶、丝绒针织涤纶和膨体聚四氟乙烯(E-PTFE),以评估其吻合口的抗张强度及其组织结构。使用可吸收的聚乙醇酸缝线,将五种长度约为3.0厘米的复合移植物植入52只成年杂种犬的腹主动脉中。植入后16周,如果复合移植物通畅,则测量双侧吻合口的抗张强度,并进行显微镜下的组织学检查。破坏丝绒编织涤纶、丝绒针织涤纶和E-PTFE吻合口所需的平均力大于编织聚四氟乙烯和编织涤纶。在编织聚四氟乙烯和编织涤纶(非丝绒移植物)的破坏部位,纤维外层明显与移植物分离。这些结果表明,纤维外层的组织和固定是动脉假体吻合口强度的最重要因素,丝绒移植物优于非丝绒移植物。E-PTFE的组织结构较差,但其抗张强度与丝绒移植物相当。考虑到E-PTFE具有非卷曲结构的优势,需要进行更长时间的进一步评估。

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