Arakaki A, Tsai T M, Firrell J C, Breidenbach W C
Department of Orthopedic Surgery, University of Kentucky, Louisville.
J Reconstr Microsurg. 1994 May;10(3):165-70. doi: 10.1055/s-2007-1006583.
The purpose of this study was to compare the microcirculation perfusion and plasma-protein extravasation in varieties of venous nerve grafts. Venous nerve grafts were created from the left median nerve and brachial vein of the rabbit. The vein was interposed between (a) brachial artery to brachial artery (AVA); or (b) brachial artery to proximal cephalic vein (AVV); or (c) brachial vein to brachial vein (VVV). A standard, vascularized, nerve graft was created in the opposite limb, to serve as a control, and the untouched sciatic nerve served as a second control. Microcirculation perfusion and permeability of endoneurial vessels were evaluated using intravenously-injected albumin labelled with Evans blue dye (EBA) as a fluorescent tracer within 1 hr after surgery. Six hours after surgery, the nerves were removed and evaluated for tracer content and distribution. Extravasation of EBA was extensive in both AVA and AVV forms of the venous nerve graft, suggesting good perfusion but showing significant protein leakage and edema. VVV, on the other hand, had only slight extravasation, comparable to untouched sciatic nerves. Although the number of vessels filled with blood in the VVV was 69 percent of the vascularized nerve graft, the lack of marked extravasation may make it the venous nerve graft of choice.
本研究的目的是比较不同类型静脉神经移植物的微循环灌注和血浆蛋白外渗情况。静脉神经移植物取自兔的左侧正中神经和肱静脉。静脉被置于以下两种情况之间：(a)肱动脉至肱动脉（AVA）；或(b)肱动脉至头静脉近端（AVV）；或(c)肱静脉至肱静脉（VVV）。在对侧肢体制作一个标准的、带血管神经移植物作为对照，未触及的坐骨神经作为第二个对照。术后1小时内，使用静脉注射用伊文思蓝染料（EBA）标记的白蛋白作为荧光示踪剂，评估神经内膜血管的微循环灌注和通透性。术后6小时，取出神经并评估示踪剂的含量和分布。在AVA和AVV形式的静脉神经移植物中，EBA的外渗都很广泛，表明灌注良好，但存在明显的蛋白质渗漏和水肿。另一方面，VVV只有轻微外渗，与未触及的坐骨神经相当。尽管VVV中充满血液的血管数量是带血管神经移植物的69%，但缺乏明显外渗可能使其成为首选的静脉神经移植物。
