Slunsky R
Zentralbl Gynakol. 1976;98(10):611-26.
Histological changes of ligated blood vessels were studied on 30 women of 41 to 57 years who had been selected according to certain criteria. For this purpose we usually resected the ligg. suspensoria ovarii, parts of the mesosalpinx, lig. latum and rotundum, the vasa uterina, segments of the basale parametrium the plexus vesico-vaginalis and others after 15 to 25 minutes. The abdominal hysterectomy was in most cases indicated due to uterus myomatosus. The histological examinations showed that, in spite of the ligation of the vessels the organism protects itself by forming a closing thrombus preventing a hemorrhage threatening life as well as a secondary hemorrhage at a later stage due to demarcation of the distal stump end. The occlusion consist of merged thrombocytes, coagulated fibrin and other blood elements; the lesion of the endothelial cells isvery important. Proximal, to the centre, the intravasal mutations decrease rapidly, the lumen is in most of the cases empty. Only in 16% of the lumina of arteries or arterioles and in 20% of the veins there were no hemostatic plugs found. The problem of hemostasis during the gynecological operation is only being touched upon, possible complications due to circulation and perfusion lesions are mentioned. A pathological extent of the coagulation in small pelvis is likely to be the reason for an embolism.
对30名年龄在41至57岁之间、根据特定标准选取的女性，研究了结扎血管的组织学变化。为此，我们通常在15至25分钟后切除卵巢悬韧带、部分输卵管系膜、阔韧带和圆韧带、子宫血管、子宫旁基底部段、膀胱阴道丛等。大多数情况下，因子宫肌瘤而行腹式子宫切除术。组织学检查表明，尽管血管被结扎，但机体通过形成封闭血栓来保护自身，防止危及生命的出血以及后期由于远端残端分界导致的继发性出血。闭塞由融合的血小板、凝固的纤维蛋白和其他血液成分组成；内皮细胞的损伤非常重要。向近端至中心，血管内的病变迅速减少，大多数情况下管腔是空的。仅在16%的动脉或小动脉管腔以及20%的静脉中未发现止血栓。妇科手术中的止血问题只是略有涉及，提到了因循环和灌注损伤可能引发的并发症。盆腔内凝血程度异常可能是栓塞的原因。
