Gremillet C, Germain M
J Chir (Paris). 1979 Apr;116(4):303-6.
The authors studied in 100 Wistar rats the manoeuvres that may commonly be carried out during vascular microanastomosis of diameter less than 3 mm (aorta and posterior vena cava): clamping for 30 to 45 minutes, bipolar electrocoagulation of the collateral arteries, more or less marked pinching of the vascular wall. The risk of thrombosis seems all the greater when: --the surgeon is inexperienced: viz. trauma with the forceps, parietal tears at the level of the stitches, two many threads passed for hemostasis (all these factors accentuate the fibrinoid and platelet deposits); --bipolar electrocoagulation of a collateral artery applied too close to the vessel to be anastomosed (less than 1 mm.)The formation of a smooth and regular fibrinous pseudo-intima appears within 48 to 72 hours which may explain the elective onset of thromboses before this delay.
作者在100只Wistar大鼠身上研究了直径小于3mm的血管(主动脉和后腔静脉)显微吻合术中常见的操作:夹闭30至45分钟、对侧支动脉进行双极电凝、或多或少明显地挤压血管壁。当出现以下情况时,血栓形成的风险似乎更大:——外科医生经验不足:即使用镊子造成的创伤、缝合处的壁层撕裂、为止血而穿过过多的缝线(所有这些因素都会加重类纤维蛋白和血小板沉积);——对距待吻合血管过近(小于1mm)的侧支动脉进行双极电凝。在48至72小时内会形成光滑且规则的纤维蛋白假内膜,这可能解释了在此延迟之前血栓的选择性形成。