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[动物实验显微手术后动脉壁的组织病理学]

[Histopathology of the arterial wall after animal experiment microsurgical operations].

作者信息

Tilgner A

出版信息

Z Exp Chir Transplant Kunstliche Organe. 1986;19(2):100-12.

PMID:3727655
Abstract

Histologic findings on microvessels of laboratory animals are reviewed. Lesions of the microvascular wall may be caused by preparation, microvascular clips and anastomosis. The intensity of the closing pressure of microclips as well as the clipping time influence the extent of the damage. Thrombosis of microarteries was not seen, even after a clipping time of 2 hours. The vascular lesions were reparable. Four different techniques of anastomosis used experimentally and clinically were compared: end-to-end suture anastomosis (absorbable and non-absorbable sutures), telescopic 2-suture anastomosis, sutureless telescopic adhesive anastomosis (fibrinogen, IMMUNO AG Wien), and telescopic 2-suture adhesive anastomosis. The tissue restitution was better in suture anastomosis carried out with absorbable sutures than performed with non-absorbable suture material. The sutureless telescopic adhesive anastomosis is a very gentle method, but the anastomoses are not always stable enough. The advantages of the telescopic 2-suture adhesive anastomosis (absorbable sutures, fibrinogen adhesive) are relatively small lesions of the vascular wall, good restitution and sufficient stability. The patency rate (96%) corresponds to that of the end-to-end suture anastomoses (94%). The clinical application of the telescopic anastomosis is estimated critically, and evidently it is more suitable for microarteries than for microveins.

摘要

回顾了实验动物微血管的组织学发现。微血管壁的病变可能由制备过程、微血管夹和吻合术引起。微血管夹的闭合压力强度以及夹闭时间会影响损伤程度。即使夹闭2小时后,也未观察到微动脉血栓形成。血管病变是可修复的。比较了实验和临床中使用的四种不同吻合技术:端端缝合吻合术(可吸收和不可吸收缝线)、套叠双缝吻合术、无缝合套叠粘合吻合术(纤维蛋白原,维也纳免疫公司)和套叠双缝粘合吻合术。使用可吸收缝线进行的缝合吻合术比使用不可吸收缝合材料进行的组织修复更好。无缝合套叠粘合吻合术是一种非常温和的方法,但吻合并不总是足够稳定。套叠双缝粘合吻合术(可吸收缝线、纤维蛋白原粘合剂)的优点是血管壁损伤相对较小、修复良好且稳定性足够。通畅率(96%)与端端缝合吻合术(94%)相当。对套叠吻合术的临床应用进行了批判性评估,显然它更适用于微动脉而非微静脉。

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