Mitchell G M, McCann J J, Rogers I W, Hickey M J, Morrison W A, O'Brien B M
Bernard O'Brien Institute of Microsurgery, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Br J Plast Surg. 1996 Jan;49(1):34-40. doi: 10.1016/s0007-1226(96)90184-8.
As many avulsion amputations are incomplete and the vessels remain intact, the immediate pathology and long-term repair process (to 3 months post-injury) of experimentally stretched but unruptured rabbit femoral arteries and veins were examined. In stretched arteries, circumferential skip lesions involving endothelium, internal elastic lamina (IEL) and media occurred frequently and often up to 3 cm from the point of stretch. Medial smooth muscle cells (SMC) were significantly damaged or lost at lesions. Macrophages and neutrophils were found in lesions 1-4 days post-injury. Between 2-4 days, lesions were covered by endothelium and synthetic state SMC appeared in the media. At 1 week, a thin neointima (which persisted to 3 months) covered many lesions. The media at lesions gradually filled with SMC but generally remained disorganised even at 3 months post-injury. Stretching caused tears in vein walls, particularly close to the point of injury. There was no evidence of venous damage or repair in specimens examined 3 weeks and 3 months post-injury.
由于许多撕脱性截肢并不完全，血管仍保持完整，因此对实验性拉伸但未破裂的兔股动脉和静脉的即时病理及长期修复过程（至损伤后3个月）进行了检查。在拉伸的动脉中，涉及内皮、内弹性膜（IEL）和中膜的周向跳跃性病变频繁出现，且常常距离拉伸点达3厘米。病变处的中膜平滑肌细胞（SMC）明显受损或缺失。损伤后1 - 4天在病变处发现巨噬细胞和中性粒细胞。在2 - 4天之间，病变被内皮覆盖，中膜出现合成状态的SMC。在1周时，一层薄的新生内膜（持续至3个月）覆盖了许多病变。病变处的中膜逐渐被SMC填充，但即使在损伤后3个月通常仍保持紊乱状态。拉伸导致静脉壁撕裂，尤其是靠近损伤点处。在损伤后3周和3个月检查的标本中，没有静脉损伤或修复的证据。
