Zeeman B J, Mitchell G M, Olazabal A E, Collopy P A, Morrison W A, O'Brien B M
Microsurgery Research Centre, St Vincent's Hospital, Melbourne, Australia.
Br J Plast Surg. 1988 Sep;41(5):509-14. doi: 10.1016/0007-1226(88)90009-4.
The significance of resection length on patency rate, and the histopathology, of microsurgically repaired avulsed blood vessels was examined at 3 weeks in two groups of experimentally avulsed rabbit femoral arteries repaired by different surgeons and in a single series of avulsed and repaired veins. All veins were patent 3 weeks after avulsion and microsurgical repair. Histopathology indicated that the vast majority of lesions in veins were removed at resection. Surgeon A achieved 75% patent arteries and Surgeon B achieved 100% arterial patency (resecting 3.7 mm more on average than Surgeon A). Histopathology revealed numerous luminal circumferential lesions remained in the avulsed artery wall following resection. These lesions were sites of smooth muscle cell proliferation and neointima formation. Although similar arterial damage occurs in human avulsion, considerably lower patency rates are achieved for human arterial avulsion repair than were reported in this experimental study. Factors in addition to vessel wall damage must therefore be involved in thrombosis and occlusion of repaired avulsed arteries. Such factors might be lengthy ischaemia time and severe spasm.
在两组由不同外科医生进行显微外科修复的实验性兔股动脉撕脱伤以及一系列单一的撕脱伤和修复的静脉中，于3周时检查了切除长度对显微外科修复的撕脱血管通畅率及组织病理学的影响。所有静脉在撕脱伤和显微外科修复后3周均保持通畅。组织病理学显示，静脉中的绝大多数病变在切除时被去除。外科医生A的动脉通畅率为75%，外科医生B的动脉通畅率为100%（平均比外科医生A多切除3.7毫米）。组织病理学显示，切除后撕脱动脉壁内仍有许多管腔周向病变。这些病变是平滑肌细胞增殖和新内膜形成的部位。尽管人类撕脱伤中也会发生类似的动脉损伤，但人类动脉撕脱伤修复的通畅率远低于本实验研究报告的水平。因此，除血管壁损伤外，其他因素必定与修复的撕脱动脉的血栓形成和闭塞有关。这些因素可能是长时间的缺血时间和严重痉挛。
