Wieslander J B, Dougan P
Department of Plastic and Reconstructive Surgery, Malmö General Hospital, Sweden.
Ann Plast Surg. 1990 Mar;24(3):216-22. doi: 10.1097/00000637-199003000-00005.
The antithrombotic effect of heparin used as a wash-out solution in small arteries has been evaluated following severe vessel trauma (arteriotomy/intimectomy). Twenty-three central arteries of rabbit ears were prepared and platelets labeled with phosphorus-32 injected intraaortically. The arteries were positioned in double vascular clamps and opened by arteriotomy, and intimectomy was performed. After reestablishing blood flow, arteriotomic bleeding times, platelet accumulation in vivo, patency, and the amounts of intraluminal red thrombotic material were recorded. The rabbits were divided into two groups. In group A (12 vessels) the vessel interior was flushed with 2 ml of saline or Ringer's lactate solution. Group B (11 vessels) was similar except that the vessels were flushed with 2 ml of heparin, 100 IU/ml, in Ringer's lactate solution. In the control group (A) the bleeding time was 5 +/- 2 min, while in group B bleeding was so profuse that extra sutures had to be used in 6 of the vessels. Although significantly fewer platelets accumulated in heparin-treated animals, the patency frequencies and amounts of thrombotic material observed in both groups were similar. The final volume of thrombus formed is thus not always proportional to the degree of platelet accumulation. Washout of small traumatized arteries with heparin is thus not beneficial.
在严重血管创伤（动脉切开术/内膜切除术）后，已对用作小动脉冲洗液的肝素的抗血栓形成作用进行了评估。制备了23只兔耳的中央动脉，并经主动脉内注射用32P标记的血小板。将动脉置于双血管夹中，通过动脉切开术打开，并进行内膜切除术。重新建立血流后，记录动脉切开术出血时间、体内血小板积聚情况、通畅情况以及腔内红色血栓物质的量。将兔子分为两组。A组（12条血管）用2 ml生理盐水或乳酸林格氏液冲洗血管内部。B组（11条血管）情况类似，只是用2 ml含100 IU/ml肝素的乳酸林格氏液冲洗血管。在对照组（A组）中，出血时间为5±2分钟，而在B组中，出血非常严重，以至于11条血管中有6条需要额外缝合。尽管肝素治疗的动物体内血小板积聚明显减少，但两组观察到的通畅频率和血栓物质的量相似。因此，最终形成的血栓体积并不总是与血小板积聚程度成正比。因此，用肝素冲洗受创伤的小动脉并无益处。
