Reichel C A, Croll G H, Puckett C L
Division of Plastic and Reconstructive Surgery, University of Missouri Health Sciences Center, Columbia 65212.
J Hand Surg Am. 1988 Jan;13(1):33-6. doi: 10.1016/0363-5023(88)90195-5.
A comparative study of irrigating solutions that contained various clot-active substances and/or vasodilating substances was done using a crush injury model of the rat's femoral artery. A routine microanastomosis was done with one of seven irrigation solutions employed in the study. The patency rate of lactated Ringer's solution (10%) (the control solution) was compared with solutions of heparin (35%) urokinase (50%), phentolamine (35%) tissue plasminogen activator (tPA) (15%), a combination of urokinase, heparin, and phentolamine (55%), and a combination of tPA, heparin, and phentolamine (42.5%). Statistically significant improvement in patency rates were obtained with heparin (p less than 0.0005), phentolamine (p less than 0.03), urokinase (p less than 0.001), the tPA, heparin and phentolamine combination (p less than 0.001), and the urokinase, heparin, and phentolamine combination (p less than 0.0001). There seems to be a benefit with the addition of either vasoactive agents or clot-active agents to the microvascular irrigating solution during construction of a compromised microanastomosis.
使用大鼠股动脉挤压伤模型，对含有各种促凝物质和/或血管舒张物质的冲洗液进行了一项对比研究。采用研究中使用的七种冲洗液之一进行常规显微吻合术。将乳酸林格氏液（10%）（对照溶液）的通畅率与肝素（35%）、尿激酶（50%）、酚妥拉明（35%）、组织纤溶酶原激活剂（tPA）（15%）、尿激酶、肝素和酚妥拉明的组合（55%）以及tPA、肝素和酚妥拉明的组合（42.5%）的通畅率进行比较。肝素（p＜0.0005）、酚妥拉明（p＜0.03）、尿激酶（p＜0.001）、tPA、肝素和酚妥拉明的组合（p＜0.001）以及尿激酶、肝素和酚妥拉明的组合（p＜0.0001）的通畅率有统计学意义的提高。在构建受损显微吻合术期间，向微血管冲洗液中添加血管活性药物或促凝药物似乎有益。
