血管吻合术对远心端血管吻合口血流量及内膜增生的影响

目的：观察不同血管吻合术对远心端血管吻合口血流量、血压以及内膜增生程度的影响。方法：16只犬随机分为偏心搭桥组和普通搭桥组行血管搭桥,搭桥后测定近心端及远心端吻合口血流量和血压值;术后3个月牺牲动物,远心端吻合口切片,测定血管内膜厚度,比较不同血管吻合术内膜增生程度。结果：（1）偏心搭桥和普通搭桥远心端吻合口血流量分别为（2.7±0.4）、（2.1±0.5）ml/s,偏心搭桥组远心端吻合口血流量显著升高（P〈0.01）;（2）偏心搭桥远心端吻合口收缩压和舒张压分别为（97±19）、（86±17）mmHg,而普通搭桥远心端吻合口收缩压、舒张压分别为（96±14）、（76±14）mmHg,偏心搭桥远组高于普通搭桥组,但无统计学意义;（3）偏心搭桥和普通搭桥远心端吻合口对应面的血管内膜分别为（60.32±3.52）、（110.50±9.62）μm,差异显著（P〈0.01）。结论：偏心搭桥能够显著增加远心端血流量,抑制搭桥术后远心端吻合口对应面的血管内膜增生。

Effects of Different Types of Bypass Vascular Anastomosis on Blood Flow and Intimal Hyperplasia at Distal Stoma

Objective：To observe the effects of different bypass vascular anastomosis methods on blood flow,blood pressure,and intimal hyperplasia at the opposite site of distal stoma.Methods：Sixteen dogs were randomly divided into two groups：eccentric bypass grafting group（group EBG）and conventional bypass grafting group（group CBG）.Blood pressure and blood flow volume at proximal and distal stoma were determined after bypass surgery.Pathological changes were observed with tissue sections and vascular intimal thickness of distal stoma was determined in 3 months after the surgery.Results：（1）The blood flow volume of EBG group（2.7±0.4）at distal stomas were significantly higher（P0.01）than those of group CBG（2.1±0.5 mL/s）;（2）Systolic blood pressure and diastolic blood pressure at distal stoma in group EBG（97±19 and 86±17 mmHg）were higher than those of group CBG（96 ±14 and 76±14 mmHg）,but the difference was not significant statistically;（3）The intimal thickness were 110.50±9.62 μm and 60.32±3.52 μm in CBG group and EBG group,respectively.The difference was statistically significant（P0.01）.Conclusions：The eccentric bypass method could inhibit intimal hyperplasia at the opposite site of distal stoma by enhancing blood flow volume.