带蒂大网膜对主动脉裂口感染的保护作用

目的探讨带蒂大网膜覆盖主动脉裂口或人造移植物对治疗主动脉裂口感染的保护作用。方法选杂种犬35条,在腹主动脉壁作全层切开造成1.2～1.5cm长裂口并予感染后,随机分为3组A组单纯缝合加大网膜覆盖组(9条犬)、B组人造血管片修补加大网膜覆盖组(11条犬)及C组对照组(15条犬),观察各组犬存活情况、大网膜与主动脉间的血循环交通情况及组织病理学改变。结果采用带蒂大网膜治疗主动脉裂口感染的死亡率显著低于对照组(3/9、3/11、15/15,P<0.01);组织学观察发现治疗组主动脉切口内面或移植物的管腔面内膜完整,周围的主动脉壁组织结构完整,亦无明显的炎性反应或异物反应;血管造影示大网膜血管与主动脉壁的滋养血管和移植物之间均有血管沟通。结论采用带蒂大网膜覆盖主动脉裂口或人造移植物,能有效地减少并发症、降低死亡率、提高治愈率。

Application of pedicled omentum to cure infected aortic wound

Objective To study the effectiveness of using pedicled omentum to cure infected aortic wound or infected aortic graft.Methods Thirty-five canines were subjected to 1.2-1.5 cm infected wound on abdominal aorta and randomized into 3 groups:group A,simply suture and omentum coverage (9 canines);group B;repair with artificial patch plus omentum coverage (11 canines) and group C,suture or repair without omentum coverage (15 canines).Survival,blood circulation and histopathology of abdominal aorta were observed.Results The mortality in groups A and B was reduced greatly (3/9,3/11 vs 15/15,P<0.01).Histopathology showed the intima of aortic artery or graft were intact and glazed,without inflammation reaction.Angiography showed new blood supply was found between omental artery and aortic artery.Conclusion Application of pedicled omentum to cure infected aortic wound or infected aortic graft can reduce mobility and mortality and improve curative rate.