动静脉转流术后静脉组织结构变化的实验观察

作者在犬的股动、静脉间,以自体小隐静脉段搭桥,形成动静脉瘘,再于瘘口远侧切断股动脉。2周后,结扎瘘口近侧的股静脉。形成动脉血循静脉逆行单向灌注。在32周观察期内,分批取出小隐静脉移植段和受灌注股静脉段,作组织学检查。结果表明:1.小隐静脉移植段管径小于0.2cm者,术后易发生闭塞;2.术后静脉的组织增生性反应,在8周后即不再发展。

Experimental Studies on Histological Changes of Venous Segment after Arteriovenous Reversal

In order to observe the long-term effect of staged arteriovenous reversal, histological studies of the bridged and bypassed veins after this procedure were made in 20 dogs. The superficial femoral artery and vein were bridged by a short segment of autogenous short saphenous vein in 40 hindlimbs and the artery was ligated distal to the fistula. Within 2 weeks post-operatively, eight specimens of the reversal were taken out for histological examination. Two weeks after fistula formation, the superficial femoral vein was ligated proximal to the fistula. During the period of 3 to 32 weeks after the frist operation, the other 32 specimens were dissected out for examination.Six transplanted veins were occluded by thromibosis(3 within and 3 after 2 weeks subsequent to the first operation). The calibers of the 6 occluded venous segments were all less than 0.2 cm, while in most of those kept patent were larger than 0.2 cm. During the period of 8 weeks after surgery, the main changes were damage and repair with mild or moderate proliferation of the endothelium, but after 8 weeks no further changes of the endothelium were found.