损伤动脉残端的病理变化

目的：探讨损伤动脉残端的病理变化,为皮瓣移植供血动脉的选择提供组织学依据。方法2007年1月-2012年2月,对15例外伤性胫前、胫后动脉及尺桡动脉损伤或缺损的动脉残端做病理取材,位置位于正常区域内发出分支前后的残端动脉主干。标本分为分支前、分支后两组,同时对炎性区域内的动脉残端取材。标本做HE染色,镜下观察血管结构变化,比较分支前后两组血管完好率,进行χ2检验。结果所有分支前组及1例分支后组标本动脉各层结构存在,无变性坏死,内膜完整。14例分支后组标本动脉结构变性坏死,内膜剥脱。两组间动脉完好率差异有统计学意义。炎性区域内动脉残端除变性坏死外,尚有大量炎性细胞浸润。结论损伤动脉残端于发出分支以前的动脉主干管壁结构存在、完好,具有做为皮瓣移植供血动脉的组织学基础。

The pathological changes of traumatic artery stump injection injuries of hand

Objective To explore the pathological changes of traumatic artery stump and provide histological evidence for the choice of recipient vessels in flap graf. Methods From January 2007 to February 2011, 15 specimens were cut from the traumatic anterior tibial artery, posterior tibial artery, ulnar and radial artery. The incision site located near the branch, the specimens were divided to two groups, one is anterior to the branch, the other is posterior. The specimens were stained by HE method, the vascular structural changes were observed under the microscope, the intact rate difference between two groups was compared using χ2 test. Results All cases of the anterior group and 1 case of posterior group had complete arterial structure and smooth intima without necrosis. But degeneration and necrosis occurred in 14 cases of posterior group. There was obvious statistical difference between two groups in intact rate. In addition to necrosis and degeneration, a large number of inflammatory cell infiltration existed in the inflammatory region. Conclusion The structure of traumatic artery stump proximal to the branch is good, it has the histological basics as donor artery for free flap transplantation.