Dippe B, Steinau H U, Schneider M, Krüger S
Abteilung für Allgemein- und Abdominalchirurgie, Technische Universität München.
Z Exp Chir Transplant Kunstliche Organe. 1990;23(2):110-5.
Arterio-venous anastomosis were recommended by some authors for tens of years especially in the revascularisation of acute and chronic ischemic extremities. A retrograde arterial perfusion was produced by microsurgical end-to-end anastomosis of the proximal femoral artery with the distal femoral vein in the pelvic extremity of rat in an experimental study. The morphologic consequences of the arterio-venous anastomosis were investigated with reference to the normal skeletal muscle structure and the muscular recovery phase after acute ischemic damage. The light microscopic changes of the muscular morphology were served as indirect proof of the effect, because the skeletal muscles showed the slightest tolerance in face of ischemia of all tissues of an extremity. The arterio-venous anastomosis for prophylaxis of postischemic skeletal muscle damages appears unfit in this experiment similar to clinical conditions. The light microscopic investigations of the skeletal muscles demonstrated an involution of the pathohistologic changes in combination of acute ischemic loading and adjunctive arteriovenous anastomosis.
几十年来,一些作者推荐使用动静脉吻合术,尤其是在急性和慢性缺血肢体的血管重建中。在一项实验研究中,通过大鼠盆腔肢体近端股动脉与远端股静脉的显微外科端端吻合术建立逆行动脉灌注。参考正常骨骼肌结构和急性缺血损伤后的肌肉恢复阶段,研究了动静脉吻合术的形态学后果。肌肉形态的光镜变化作为该效应的间接证据,因为在肢体的所有组织中,骨骼肌对缺血的耐受性最低。在本实验中,类似于临床情况,用于预防缺血后骨骼肌损伤的动静脉吻合术似乎并不合适。骨骼肌的光镜检查显示,在急性缺血负荷和辅助动静脉吻合术的联合作用下,病理组织学变化出现退化。