自体静脉移植修复四肢陈旧性动脉损伤的实验研究

目的探索自体静脉移植修复陈旧性动脉损伤的时机，为临床提供有关实验依据。方法建立家兔四肢陈旧性动脉损伤的动物实验模型，在股动脉损伤１５、３０、４５、６０、７５、９０天后，用自体静脉移植修复。术后８周进行活体观察及血流动力学观察后取材送组织细胞学检查。结果３９条移植静脉１１条栓塞，总通畅率为７１．８％。损伤后１５、３０、４５天组明显优于其它时间组（Ｐ＜０．０１）。实验侧末梢皮温较术前均有升高，但７５、９０天组不明显。多普勒超声检测：末梢血管床阻力增加，血流灌注不良。组织学观察：移植血管内膜增生、移植静脉管壁增厚，内膜增生程度随动脉损伤时间的延长而加重。结论静脉移植距动脉损伤时间的长短，对移植血管远期通畅率有明显的影响。陈旧性动脉损伤应争取在伤后２个月内修复。

An experimental study on repair of old arterial injury in the extremities by autologous venous transplantation

Objective To investigate the suitable time in repairing old arterial injury in the extremities by autologous venous transplantation and provide experimental basis to clinical application. Methods Autologous venous transplantation was performed in rabbit of old arterial injury in the extre mities on 15, 30, 45, 60, 75 and 90 days after injury. Histology, cytology and hemodynamics of the transplanted veins were studied 8 weeks after the operation. Results Among 39 transplanted veins, the overall patency rate was 91.79Conclusions The interval between injury of the artery and autologous venous repair had great influence on the patency rate of transplanted veins ,thus old arterial injury should be repaired within 2 months.